Ace Icd-9 And Cpt Coding For Intra Arterial Cases

By Author: Nancy Rose
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Ace ICD-9 & CPT coding for intra-arterial cases


Irrespective of whether liver neoplasm is primary or secondary, it'll certainly change your coding.


Good tidings: You may apply many of the same rules you already know for intravenous chemotherapy coding to intra-arterial coding too. As such, take your chemo coding expertise to the next level by adding intra-arterial skills to your arsenal.


Begin here: For intra-arterial (IA) chemotherapy, you should select from the following codes, according to Gwen Davis, CPC, associate with Washington-based Derry, Nolan, and Associates.


96420 — Chemotherapy administration, intra-arterial; push technique
96422 — infusion technique, up to one hour
+96423 — infusion technique, each additional hour, (List separately in addition to code for primary procedure)
96425 — infusion technique, initiation of prolonged infusion (more than eight hours), requiring use of a portable or implantable pump.


Make ...
... a comparison of 96420-96425 applications


Push: According to Davis, for an IA chemotherapy push, you should go for 96420. You should apply the same CPT definitions for a "push" to both IA and intravenous (IV) administration:


(a) "An injection in which the healthcare professional who administers the substance/drug is continuously present to administer the injection and observe the patient"


OR


(b) "an infusion of 15 minutes or less."


Infusion: For infusion by temporary catheter, a physician often times places the catheter into the artery supplying blood to the tumor. Infusion code 96422's definition specifies "up to one hour," while +96423 specifies "each additional hour."owever, just as with IV infusion codes, CPT indicates you should go for the "additional hour" code for infusion intervals of greater than 30 minutes beyond one-hour increments," says Davis. As such, if the infusion lasts one and a half hours, you should only go for 96422 (without adding +96423) as the time has not reached the "greater than 30 minutes" needed for +96423.


Pump: Infusion by pump is a common method of intra-arterial administration. Go for 96425 for prolonged infusions that call for a portable or implantable pump and last more than eight hours. This code describes only the initial service; as such if your practice carries out refilling or maintenance, you should select the right code from 96521-96523, just as you would for an IV pump service. Remember: For Medicare and other payers whose contracts indicate they process claims as per National Correct Coding Initiative (CCI) logic, see to it to follow the guidelines in CCI Manual, chapter 11, section N.5 (www.cms.gov/NationalCorrectCodInitEd). According to the manual, you should not report 96521-96522 alongside 96425 as 96425 covers "the initial filling and maintenance of a portable or implantable pump."


Train eyes on liver for likely diagnoses


Two of the common diagnoses treated by IA chemotherapy are primary liver neoplasm and a secondary liver neoplasm that metastasized from the colon. To get to know more about diagnosis coding, sign up for Oncology Coding Alert.