sroller
Contributor
I have a question about what you do in the event where a patient's pump leaks and they need to come back in and if there is anything that should be charged for such a visit?
Example-
Patient has scheduled appointment on 12/31 for normal therapy plan which includes Adrucil pump to be activated and will infuse over 46 hours.
Patient calls 1/02 to report pump leaked overnight. Pump was turned off and bagged at a different facility. Patient will come in to have the remaining 25mL infused and will have it disconnected at a different facility tomorrow.
Patient arrives for the remaining 25mL to be re-started through CADD pump. Pump was checked by RN, which observed pump to be visibly soiled, RN able to observe 5FU dried residue on outside of CADD pump bag and on tubing. Appears leak occurred at the connection of the OnGuard adapter that was closest to the pump and the IV tubing.
Patient given new CADD pump and bag. Re-hooked to 5FU at (time), see MAR.
Appointment scheduled at outside facility for pump DC and information given to patient, patient agreeable.
Soiled CADD pump with chemo residue to be cleaned by pharmacy and then pump to be shipped back to infusion pump company to perform quality control check.
Charges were billed as normal on original day, 12/31, 96416 included. They are trying to bill 96416 on 01/02 as well, I think this is incorrect since we already billed it on 12/31 and it was a pump malfunction and we aren't technically restarting a pump. We are just finishing what is left of the original start of the pump on 12/31. Some question as to if we can bill 96521, I can somewhat understand maintenance as we are having to go through the issues with the old pump and have pharmacy clean it and initiate a new pump to finish the rest of the infusion but again I don't think that can be billed because we aren't 'refilling' anything, we are simply just using what was left in the bag. The most I am finding is billing an E/M code for the visit, but I am confused on if that should even be done because it's all done by an infusion RN and the patient is seen in the infusion department. He is not seeing his medical oncology provider for this where we would normally bill a professional E/M and a facility E/M for a visit.
Please help!!
Example-
Patient has scheduled appointment on 12/31 for normal therapy plan which includes Adrucil pump to be activated and will infuse over 46 hours.
Patient calls 1/02 to report pump leaked overnight. Pump was turned off and bagged at a different facility. Patient will come in to have the remaining 25mL infused and will have it disconnected at a different facility tomorrow.
Patient arrives for the remaining 25mL to be re-started through CADD pump. Pump was checked by RN, which observed pump to be visibly soiled, RN able to observe 5FU dried residue on outside of CADD pump bag and on tubing. Appears leak occurred at the connection of the OnGuard adapter that was closest to the pump and the IV tubing.
Patient given new CADD pump and bag. Re-hooked to 5FU at (time), see MAR.
Appointment scheduled at outside facility for pump DC and information given to patient, patient agreeable.
Soiled CADD pump with chemo residue to be cleaned by pharmacy and then pump to be shipped back to infusion pump company to perform quality control check.
Charges were billed as normal on original day, 12/31, 96416 included. They are trying to bill 96416 on 01/02 as well, I think this is incorrect since we already billed it on 12/31 and it was a pump malfunction and we aren't technically restarting a pump. We are just finishing what is left of the original start of the pump on 12/31. Some question as to if we can bill 96521, I can somewhat understand maintenance as we are having to go through the issues with the old pump and have pharmacy clean it and initiate a new pump to finish the rest of the infusion but again I don't think that can be billed because we aren't 'refilling' anything, we are simply just using what was left in the bag. The most I am finding is billing an E/M code for the visit, but I am confused on if that should even be done because it's all done by an infusion RN and the patient is seen in the infusion department. He is not seeing his medical oncology provider for this where we would normally bill a professional E/M and a facility E/M for a visit.
Please help!!