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Report one drug administration charge for triple lumen

APCs Weekly Monitor, October 13, 2006

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Report one drug administration charge for triple lumen

QUESTION: If ED staff use a triple lumen to peripherally insert a central catheter (PICC) into a patient, can we charge only one initial drug administration code, or can we charge three initial codes? My thinking is that because there is only one main access site, there can only be one initial drug administration, but I would like your thoughts.

ANSWER: Bill only one drug administration charge in this instance. The November 2005 CPT Assistant, pp. 2-3, addresses this question. It states

When administering multiple infusions, injections, or combinations, only one "initial" service code should be reported, unless the protocol requires that two separate IV sites be utilized. If an injection or infusion is of a subsequent or concurrent nature, even if it is the first such service within that group of services, then a subsequent or concurrent code from the appropriate section should be reported (e.g., the first IV push given subsequent to an initial one-hour infusion is reported using a subsequent IV push code).

Report the initial code that best describes the primary, most significant service provided to the patient.

For another reference, Blue Cross Blue Shield of Kansas published an excellent guide in December 2005 titled 2006 Injections and Infusion Administration Codes for Chemotherapy and Non-chemotherapy Drugs. You can find it at its web site: http://www.bcbsks.com.

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