Drug administration coding doesn't need to be difficult.
Drug administration is one of the most common services provided in the outpatient setting, and while the rules and codes have not changed significantly since 2009, coders still have questions about how to apply the CPT® guidelines and follow CMS' guidance.
This handbook begins with a review of drug administration concepts, including definitions of common terms. It then walks through the hierarchy that outpatient facility coders use to select the initial drug administration service. The handbook also explains how to properly determine when to report concurrent, subsequent, and additional hours of substances and when to report hydration.
Included are 15 case examples of varying complexity for coders to test their understanding of drug administration principles. The correct coding for each example is provided, along with explanations highlighting key code assignment concepts. The handbook concludes with some frequently asked questions about drug administration.
Resolve your toughest drug administration coding challenges!
Table of Contents
Introduction
Definition of drug administration terms
Importance of correct drug administration reporting
CPT coding
Codes and coding guidelines
Drug administration hierarchy
Documentation requirements
CPT vs. Medicare rules
Coding scenarios
Chemotherapy
Multiple infusions
Subsequent drug administration
Concurrent infusions
Multiple drug pushes
Hydration
Coding scenario answers and explanations
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Jugna Shah, MPH, is the president and founder of Nimitt Consulting, Inc., a firm specializing in case-mix payment system design, development, and implementation. She has extensive experience helping providers understand and address the ongoing clinical, operational, and financial implications of Medicare's outpatient prospective payment system based on APCs. She has educated and audited hospitals on their drug administration coding and billing practices. Shah has contributed to several books and numerous OPPS/APC articles over the past 14 years. She is also a contributing editor of HCPro's Briefings on APCs.
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