Corporate Compliance

Injections and infusions: Understand recent changes to head off problems

Health Care Auditing Strategies, April 1, 2006

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With 2006 drug administration CPT and HCPCS changes and unclear explanations from CMS, your hospital's staff may struggle with how to correctly apply new codes. To head off potential compliance and revenue problems, consider conducting an audit as soon as possible.

The basics

The American Medical Association (AMA) issued 33 new CPT codes for reporting drug administration services in the CPT 2006 manual. Providers can only use 20 of these 33 CPT codes for Medicare reporting. CMS replaced the remaining 13 CPT codes with the following HCPCS C codes (the 2005 CPT codes are in italics for crosswalk purposes):

  • C8950, IV infusion for therapy/diagnosis; up to one hour. Formerly 90780.
  • C8951, IV infusion for therapy diagnosis; each additional hour (list separately in addition to C8950). Formerly 90781.
  • C8952, Therapeutic, prophylactic, or diagnostic injection; IV push. Formerly 90784.
  • C8953, Chemotherapy administration, IV; push technique. Formerly 96408.
  • This is an excerpt from a member only article. To read the article in its entirety, please login.

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