Simplify Your Photodynamic Therapy Claims With This Advice
Posted on 09. Apr, 2012 by dchandhok in Hot Coding Topics
A patient with cancer comes for treatment to your pulmonologist, who makes use of photodynamic therapy (PDT) to treat her. Which key components of the therapy that you need to pay attention to? Here are some refresher tips to help you report photodynamic therapy with confidence.
Capture All Aspects of the Infusion
The first step to photodynamic therapy is the intravenous infusion of Photofrin (Porfimer), which could be performed by your pulmonologist or by a nurse under your pulmonologist’s supervision. “If performed in the hospital, no charge can be made. If performed in the office, a charge can be made even though performed by a nurse since she will be supervised by the pulmonologist,” says Alan L. Plummer, MD, Professor of Medicine, Division of Pulmonary, Allergy, and Critical Care at Emory University School of Medicine in Atlanta.
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“The infusion of Photofrin should take about 10-15 minutes,” says Plummer. “If the infusion lasts less than 30 minutes, use code 96374 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; intravenous push, single or initial substance/drug),” he advises. “If the infusion lasts over 30 minutes, use 96365 (Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour).”
In addition to the infusion, you will need to report the J code for Photofrin. You will report this with J9600 (Injection, porfimer sodium, 75 mg).
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