Chemotherapy Infusion Administration Codes 96413 and 96415
Chemotherapy infusion administration codes 96413 (Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug) and code 96415 (each additional hour (List separately in addition to code for primary procedure)) are appropriate when billing Medicare for parenteral administration of nonradionuclide anti-neoplastic drugs. Chemotherapy infusion administration codes are also appropriate when physicians provide anti-neoplastic agents for the treatment of noncancer diagnoses or for substances such as monoclonal antibody agents and other biologic response modifiers. Generally drugs such as Infliximab (Remicade ®), Rituximab (Rituxan®), Alemtuzumab (Campath®), Gemtuzumab (Mylotarg®) and Trastuzumab (Herceptin®) are considered to fall under the category of monoclonal antibodies.
However, codes 96413 and 96415 are not appropriate for the administration of anti-anemia drugs and anti-emetic drugs by injection or infusion for cancer patients. Such services are reported using CPT codes from the range 90765-90775. Additional information regarding chemotherapy infusion administration codes is addressed in the WPS Medicare National Coverage Provision (NCP) HONC-002, "Chemotherapy and Drug Administration." Please visit our policy website to view the NCP.
Page Last Updated: Tuesday, 15-Jul-2008 10:45:17 CDT
