90768 Concurrent infusion (List separately in addition to code for primary procedure) 9 90765 for the first antibiotic 90768 for the concurrent infusion of antibiotic 90775 for the sequential IV push
Intravenous therapy is a therapy that delivers fluids directly into a vein. The intravenous route of administration can be used for injections or infusions. Intravenous infusions are commonly referred to as drips. The intravenous route is the fastest way to deliver medications and fluid replacement throughout the body, because the circulation carries them. Intravenous therapy may be used for fluid replacement, to corr…
ICD-10-CM Diagnosis Code T36. Poisoning by, adverse effect of and underdosing of systemic antibiotics. Systemic antibiotics; antineoplastic antibiotics (T45.1-); locally applied antibiotic NEC (T49.0); topically used antibiotic for ear, nose and throat (T49.6); topically used antibiotic for eye (T49.5) ICD-10-CM Diagnosis Code T36.
Oct 01, 2015 · ICD-10-PCS › 3 Administration › E Physiological Systems and Anatomical Regions › 0 Introduction › 3 Peripheral Vein › 2022 ICD-10-PCS Procedure Code 3E033GC; 2022 ICD-10-PCS Procedure Code 3E033GC Introduction of Other Therapeutic Substance into Peripheral Vein, Percutaneous Approach
ICD-10-CM Diagnosis Code T41.1X5D Adverse effect of intravenous anesthetics, subsequent encounter 2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code POA Exempt
The Current Procedural Terminology (CPT) codebook contains the following information and direction for the Chemotherapy and Other Highly Complex Drug or Highly Complex Biological Agent Administration CPT® codes: “Chemotherapy Administration codes 96401-96549 apply to parenteral administration of non-radionuclide anti-neoplastic drugs; and also to anti-neoplastic agents provided for treatment of non-cancer diagnoses (e.g. cyclophosphamide for auto-immune conditions) or to substances such as certain monoclonal antibody agents, and other biologic response modifiers. The highly complex infusion of chemotherapy or other drug or biologic agents requires physician or other qualified health care professional work and/or clinical staff monitoring well beyond that of therapeutic drug agents (96360-96379) because the incidence of severe adverse patient reactions are typically greater. These services can be provided by any physician or other qualified health care professional. Chemotherapy services are typically highly complex and require direct supervision for any or all purposes of patient assessment, provision of consent, safety oversight, and intraservice supervision of staff. Typically, such chemotherapy services require advanced practice training and competency for staff who provide these services; special considerations for preparation, dosage, or disposal; and commonly, these services entail significant patient risk and frequent monitoring. Examples are frequent changes in the infusion rate, prolonged presence of the nurse administering the solution for patient monitoring and infusion adjustments, and frequent conferring with the physician or other qualified health care professional about these issues. When performed to facilitate the infusion of injection, preparation of chemotherapy agent (s), highly complex agent (s), or other highly complex drugs is included and is not reported separately. To report infusions that do not require this level of complexity, see 96360-96379. Codes 96401-96402, 96409-96425, 96521-96523 are not intended to be reported by the individual physician or other qualified health care professional in the facility setting.”
Medicare has determined under Section 1861 (t) that these drugs may be paid when they are administered incident to a physician’s service and determined to be medically reasonable and necessary. Such determination of reasonable and necessary is currently left to the discretion of the Medicare Administrative Contractors (MACs). The documentation in the patient’s medical record must support the drugs as being medically reasonable and necessary.
J1442, Q5101 or Q5110: The subcutaneous or intravenous formulation of filgrastim needs to be billed with the JA (intravenous) or JB (subcutaneous) modifier.
Intravenous (IV) infusions are billed based upon the CPT®/HCPCS description of the service rendered. A provider may bill for the total time of the infusion using the appropriate add-on codes (i.e. the CPT®/HCPCS for each additional unit of time) if the times are documented. Providers may not bill separately for items/services that are part of the procedures (e.g., use of local anesthesia, IV start or preparation of chemotherapy agent).
Only one initial code is allowed per patient encounter unless two separate IV sites are medically reasonable and necessary (use modifier 59). If the patient returns for a separate and medically reasonable and necessary visit/encounter on the same day, another initial code may be billed for that visit with CPT® modifier 59.
When requested, providers should submit documentation indicating the volume, start and stop times, and infusion rate (s) of any drugs and solution provided. In the absence of the stop time the provider should be able to calculate the infusion stop time with the volume, start time, and infusion rate.
An IV push is an infusion of 15 minutes or less and requires that the health care professional administering the injection is continuously present to observe the patient.
There is no concurrent code for either a chemotherapeutic IV infusion or hydration. Can a concurrent infusion be billed?