Revenue Cycle

OPPS vs. CPT: Coding ­injections and infusions

Briefings on APCs, May 1, 2011

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Coders already know that CMS doesn't always follow the language in the CPT Manual. The most recent example is the use of initial codes for injections and infusions when a patient's visit lasts past midnight and the service is not continuous. Although the AMA added new introductory text to the 2011 CPT Manual addressing this scenario, that guidance only ­applies to physician reporting, not hospitals. Facilities could receive significant overpayments if their coders ­apply the wrong guidelines.

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