tci Part B Insider - 2013 Issue 40

Reader Question: Know the Rules for Add-ons

Question: Our physician recently performed the infusion of two anti-neoplastic substances for a patient. I am getting confused about the use of the codes and add-on codes that I have to use to report the infusion procedures? Should I report the primary code (96413) for each substance or report it only once for the session? Answer: When reporting an infusion of any substance for chemotherapy, you will have to report the initial one hour of infusion with 96413 (Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug). You’ll use this code only once per...

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