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Kelly Posted Tue 26th of September, 2017 16:50:18 PM
What is the correct CPT code for the administration of Brineura(Cerliponase alfa)? *This drug is used to treat late infantile neuronal ceroid lipofuscinosis type 2. This drug is administered into the cerebrospinal fluid by way of a surgically implanted reservoir and catheter of an intraventricular access device.
SuperCoder Answered Wed 27th of September, 2017 05:50:41 AM

Hi, 

  • Brineura is administered into the cerebrospinal fluid (CSF) by infusion via a surgically implanted reservoir and catheter (intraventricular access device) If the provider documented that he injected a substance or medication with either a diagnostic or therapeutic intent, you report code 61026 for administration.
  • HCPCS code J3490 for Brineura(Cerliponase alfa) along with administration code.
  • If the administered drug is infused for the chemotherapeutic purpose then CPT code 96542 would be appropriate. 

 Hope this helps!

Kelly Posted Wed 27th of September, 2017 10:00:01 AM
Thank you for your response. The Brineura(Cerliponase alfa)is infused over 4 hours (not as an injection). Both codes referenced are for injections not infusions. For 96542-I have read that it is for reporting the professional component only. I am billing for the hospital/facility component. Patient has batten's disease, so not sure if this is considered chemo. Thoughts? 61026 Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; with injection of medication or other substance for diagnosis or treatment 96542 Chemotherapy injection, subarachnoid or intraventricular via subcutaneous reservoir, single or multiple agents
SuperCoder Answered Thu 28th of September, 2017 06:38:22 AM

Hi,

CPT code 96379 unlisted therapeutic, prophylactic, or diagnostic intravenous or intra-arterial injection or infusion seems appropriate as there is no specific code for interventricular infusion per the current scenario described and also check with your payer for reimbursement.

Use HCPCS code J3490 or J3590 for Brineura(Cerliponase alfa) along with administration code.

Hope this helps!

 

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