Health Information Management

Tip of the Week: Follow these drug administration guidelines

APCs Insider, March 30, 2007

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Be aware of the following concepts/guidelines when coding drug administration claims:

  • Report short duration infusions (15 minutes or less) using an IV push injection code. This applies to chemo and non-chemo infusions.
  • Consider all initial/first-hour infusions as lasting from 16-90 minutes. Report infusions less than 16 minutes with an IV push injection code; report the "each additional hour" codes when the infusion lasts 91 minutes or more.
  • You can separately report multiple infusions of different substances/drugs (i.e., chemotherapy and non-chemotherapy) through the same line.
  • Hospital outpatient departments meet all physician supervision requirements for CPT codes 90760-90779 and 96401-96549 (per Medicare Benefit Policy Manual, Pub. 100-02, Chapter 6, Section 20.4.1).
  • When an infusion is started outside the hospital (e.g., in an ambulance), you can bill for all services provided once the patient enters the hospital, including an initial hour of infusion-even when hospital staff did not initiate the infusion.

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