Remicade in-office a good service, but may not help bottom line

Why This Topic Matters

Practices considering infusion therapy need to understand both the operational requirements and the coding/documentation elements that affect reimbursement. The article helps readers assess whether an in-office infusion program is likely to be viable under common payer and Medicare payment structures.

Article Sections

1. Sample ICD-9 to prove medical necessity for Crohn’s

   Provides a general discussion of diagnosis documentation for Crohn’s disease and related fistula documentation used to support medical necessity. The section also identifies the source of the guidance.

2. Ask yourself these questions about Remicade in-office

   Reviews broad payer and site-of-service considerations that practices may evaluate before offering infusion services in the office. It also addresses network status and authorization issues at a high level.

3. Coding for Remicade reimbursement

   Summarizes the coding and documentation topics associated with reporting infusion therapy and infliximab reimbursement, along with general Medicare-related billing context.