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Issue Number - Name
0071 - Initial Hydration, Infusion and Chemotherapy Administration
Review Type
Automated
Claim Type
Professional Services (Physician/Non-Physician Practitioner)
Region and State
RAC 1-4
All States
Date Approved
2017-10-05

Description

When administering multiple infusions, injections or combinations, the physician should only report one "initial" service code unless protocol requires that two separate IV sites must be used. For these separate identifiable services, physicians need to report with using modifier 59, XE, XS, XP or XU.

Affected Code(s)

  • 96360, 96365, 96369, 96374, 96409, 96413

Applicable Policy References

  • CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 12, Section 30.5