1. Jennifer Upchurch
   Posted 7 months ago #
   

   When coding a port flush or chemotherapy we usually bill out J1642 x 50 units and J7050x (whatever units necessary for chemo). My billing office states that this is a bundled charge and should not be billed to Medicare. Everything I have read on the subject, specifically for the J1642 I read it as we should not bill for the heparin when doing a port flush. The begininning of this year my office had paid an auditing company to make sure that we were billing correctly. When I brought up this topic he said that yes we are billing correctly and should put the heparin and the saline flush on the claim. Which is the correct to do?

2. SuperCoder
   Posted 7 months ago #
   

   GUIDELINES
   ==========
   If performed to facilitate the chemotherapy infusion or injection, the following services and items are
   included and are not separately billable:
   - Use of local anesthesia.
   - IV access.
   - Access to indwelling IV, subcutaneous catheter or port.
   - Flush at conclusion of infusion.
   - Standard tubing, syringes and supplies.
   - Preparation of chemotherapy agent(s).
   *
   Payment for the above is included in the payment for the chemotherapy administration service.
   *

   If a significant separately identifiable E/M service is performed, the appropriate E/M code should be reported utilizing modifier 25 in addition to the chemotherapy code. For an E/M service provided on the same day, a different diagnosis is not required.

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