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ReginaR

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Hello All: I need some input. I was posed with a few questions this morning that I don't know how to answer. Here we go.
My boss calls me this morning to ask me how to bill out a "biological" drug that has the generic J9999 code. When asked what it was, she didn't tell me. I explained to her that J9999 is generic and that NDC number is required. She wanted to know the course we would use to administer. I told her 96413 for chemo and 96565 for non-chemo. She asked if there was a code for "mixing" the drug.

Does anyone know if there is a CPT code for "mixing" chemotherapy?
Does anyone know how to bill out a "biological" drug that is natural?

I am at a loss here and was told to "find out" these questions.

Thanks everyone. Your input would be greatly appreciated.
Regina
 
if by biological you mean biological response modifier (BRM) .. then no there is no code to be able to charge for mixing the drug, sorry.
Chemotherapy administration codes apply to parenteral administration of nonradionuclide
anti-neoplastic drugs; and also to anti-neoplastic agents provided for treatment of noncancer diagnoses (e.g., cyclophosphamide for auto-immune conditions) or to substances such as monoclonal antibody agents, and other biologic response modifiers.
Medicare Regulation Excerpts:
PUB.100-20 One time Notification (OTN); Change Request (CR) 3818, 3631, 3028)
For services furnished on or after January 1, 2005, chemotherapy administration codes apply to parenteral administration of nonradionuclide anti-neoplastic drugs and also to anti-neoplastic agents provided for the treatment of noncancer diagnoses (e.g., cyclophosphamide for auto-immune conditions) or to substances such as monoclonal antibody agents and other biologic response modifiers. Administration of anti-anemia drugs and anti-emetic drugs by injection or infusion for cancer patients is not considered chemotherapy administration.
 
Thank you for answering me. Just for clarification, no CPT for mixing of drug as it is inclusive to the administrative fee (which is what I originally thought). But my question is, is the biological then given 96365?

Also, would you be able to send me a link to the information that you sent so that I can print out for my boss.

Thank you
Regina
 
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