Wiki Pump Connect/Disconnect Charge Question

[tonplair@gmail.com]

If a patient has a Pump disconnect (96523) and a Reconnect (96416) on the same day, can we charge both codes, using a 59 modifier on the reconnect.
Usually, this is done on separate days but we have a patient that this is being done on the same day.
Thanks!

 

[creinhardt]

No, the paranthetical notes in CPT for code 96523 state, "Do not report 96523 in conjunction with other services."

 

[plugger10]

You should not bill 96523 as a pump disconnect. That is a refill and maintainance code and would only be used if you were restarting the pump the same day (i.e. placing a new drug cassette for the pump). You should bill 99211 for a pump that is discontinued and not restarted that same day.