1. Chen Huang
   Posted 8 months ago #
   

   hello there,
   how would i bill a patient for magnesium?

2. Chen Huang
   Posted 8 months ago #
   

   Sorry, my assistance is who posted this questions. Let me pose it in another way. I have a case like this- please see how this is billed as we are not sure.

   Cisplatin and taxol for lung cancer.

   1) decadron 10 mg ivp
   2) benadryl 25 mg ivp
   3) zofran 8 mg ivp
   4) prehydration with meds and ciplatin

   d5half NS with kcl 20 meq and mannitol 12.5 and magnesium 2 grams along with cisplatin 30 mg= everything is ran over 4 hours

   5) taxol 90 mg iv over 3 hours

   Can you please clarify how to bill something like this? Of course everything is going into the same iv, no meds are given simultaneouly other than the IV with the cisplatin, mg, kcl and mannitol.

   Thanks,

   Chen~

3. SuperCoder
   Posted 8 months ago #
   

   I think you know the codes for these drugs, and you have problem in coding the administration of injections. When all these drugs are injected at the same time through same IV along with NS, then we can bill for the total duration of IV drug introduced:

   When coding multiple-substance infusion claims, report the initial infusion with 96365 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; initial, up to 1 hour). If the initial infusion lasts more than an hour, include +96366 (? each additional hour [List separately in addition to code for primary procedure]) for each additional infusion hour
   For details plz refer to:
   http://www.supercoder.com/code-lookup/cpt/codes/?code=96366

4. Chen Huang
   Posted 8 months ago #
   

   You realize that cisplatin is a chemotherapy correct?

   4 hours was the concoction with cisplatin
   3 hours the taxol alone.

   Someone suggested that it should be:

   96413 x 1 and the subsequent hours
   96451 x (3+3=6) x 6

   Can you please break it down how it should be?

   Thanks,

   Chen~

5. SuperCoder
   Posted 8 months ago #
   

   Hi Chen, Initially it was posted for Magneseum, and then posted in a bigger scenario. I thought the focus of question is on magneseum and other non-chemotherapy based therapeutic ones.

   It was not clear if it was separate access site for each of these or same access site. I am presuming these in same access site.

   For Chemotherapeutic Infusion(Cisplatin, Taxol, Decadron): Since no separate access, so I am taking the max duration: 4 hours
   96413 x1
   96415 x3

   For additional non-chemotherapeutic infusion,check the appropriateness of 96366 or 96367 or 96368.
   For Concurrent Infusion of Non-chemotherapeutic drug (Benadryl,Zofran,Mannitol,Mg): Max 4 hrs here in case of Mannitol and Mg.
   Need to check if the additional non-chemotherapeutic infusions, whether these are sequential infusions or concurrent infusions.
   If sequential infusions, then 96367x4
   If concurrent infusions, then 96368x4

6. Chen Huang
   Posted 8 months ago #
   

   Hi Sanjit,

   I am not clear yet...

   For taxol alone, since this is the initial chemo then 96413x1

   The cisplatin was given in ONE LITER bag of D5 half NS over 3 hours or so, that contained also
   1) magnesium 2 grams
   2) mannitol 12.5 grams
   3) KCL 10-20 meq

   So I am thinking this should be 96415 x 3 hours for cisplatin
   then additional CONCURRENT med 96368x 3 for the concurrent 3 drugs.

   Thanks for your attention.

   CH~

7. Chen Huang
   Posted 8 months ago #
   

   Of course everything is going into one iv, taxol first and then the cisplatin bag with all the other drugs. Thanks,

   Chen~

8. Chen Huang
   Posted 8 months ago #
   

   Sorry,

   taxol is 3 hours and cisplatin is 3 hours

   TAXOL 96413 x1 and 96415 x2
   CISPLATIN 96415x 3
   MAGNESIUM 2gm, KCL 20 meq, MANNITOL 12.5 gm is 96368 x 3

   Please advise,

   Thanks.

   Chen~

9. SuperCoder
   Posted 8 months ago #
   

   Absolutely correct.

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