How to Correctly Code and Bill Remicade Injection?

How to correctly code and bill remicade injectionQuestion: A patient with Rheumatoid Arthritis presents for a Remicade Injection(Infliximab) and receives two pushes, one of Benadryl and one of Solumedral. A recommended dose of Inliximab 200 mg was administered for 3 hrs by means of an intravenous infusion. How would you report these services ?

Answer: The correct way to report these services would be:

Dx Code: 714.0 (Rheumatoid Arthritis)

Pre Medication: 96375 X 2 (Total of 2 pushes); J1200 X 1 unit (Benadryl); J2930 X 1 unit (Solumedrol)

Infusion: 96413 ( Infusion first hour); 96415 X 2 ( two additional hours); J1745 X 20 units (Remicade 200 mg). NOTE:This product is billed by 10 mg units so that 10 units are all within a 100 mg vile).

Certain payer policies for IV therapy codes may vary. Some may prefer to use CPT codes:

96365(Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial upto 1 hour)

96366(Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour).

Please consult your local payer for specific coding policies.

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