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Lina Posted Tue 25th of April, 2017 12:58:18 PM
Hi, can you please tell me if I can submit J2786 with cpt code 96413 instead of 96365 for pulmonology specialty?
SuperCoder Answered Wed 26th of April, 2017 04:12:00 AM

Hi,

J2786 (One unit of this code represents a 1 mg injection of reslizumab for the maintenance treatment of severe asthma in patients 18 years old and older. It is used to prevent severe asthma attacks or exacerbations by reducing levels of a certain type of white blood cells)

96365 used for intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug) initial, up to 1 hour.

 96413 Chemotherapy administration, intravenous infusion technique up to 1 hour, single or initial substance/drug.

Cpt code 96413 is for chemotherapy drug administration and the scenario described above is for J2786 which is not used here as chemotherapy drug. Hence cpt code 96365 is most appropriate code with J2786.

Hope this helps!

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