Several outpatient infusion coding and payment changes will take effect in 2009 that could impact the way ID practices code for drug administration services and bill for the drugs.
The current procedural terminology (CPT) infusion and injection codes for hydration and for non-chemotherapy therapeutic, prophylactic, or diagnostic drug administration have been renumbered. The code changes, along with coding instructions and payment rates, are available on the IDSA website. (Login required). The changes take effect Jan. 1.
The codes were renumbered so that they would be adjacent to the chemotherapy administration codes in the 2009 CPT codebook for ease of reference to providers and their billing staff. There are no changes in the definitions.
Beginning in 2009, these infusion and injection codes are also available for hospitals and other inpatient facilities. Please refer to the CPT codebook for instructions on how to report these codes in inpatient settings.
Additional IVIG Payment Ends
In another change for 2009, the temporary payment Medicare offered physicians for infusing intravenous immune globulin (IVIG) has expired.
The Centers for Medicare and Medicaid Services (CMS) established a temporary G-code (G0332) for 2006-2008 to compensate physicians after supply shortages pushed the cost of IVIG over the Medicare reimbursement rate. CMS says the shortage has abated. IDSA continues to monitor the situation.
Finally, Medicare has postponed the competitive acquisition program for Part B drugs and biologicals. More information is available on the IDSA webiste.
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