Avoid audit risk for your infusion and injections therapy services.
Each year, infusion and injection therapy services continue to be one of the most difficult — and highest risk — areas for coding and documentation, according to our consulting experts. With coverage and guidance changing for services provided in an observation setting, new targeted audit areas, appropriate use of modifiers, and continual uncertainty with documentation requirements for hydration therapy, chemotherapy, transfusions, and vaccines, there’s one thing you can do to get it right: Make sure you have our comprehensive and practical resource at your fingertips.
The Coding Essentials for Infusion and Injection Therapy Services walks you through AMA and CMS guidelines for coding and documenting infusion and injection services in all settings. Services covered include hydration therapy, drug administration, chemotherapy, blood collection and transfusion, therapeutic pheresis, declotting vascular access devices, vaccines/toxoids and therapeutic phlebotomy. You also get Medicare payment information.
This trusted resource also will help you avoid issues that can lead to noncompliant billing or missed revenue opportunities. For example, does your nursing documentation accurately reflect start and stop times for hydration therapy? Is there confusion over the use of CPT® code 96413 for chemo intravenous infusion? Do you clearly understand the distinction between the intravenous injection (IV push) procedure and sub-Q or IM injections? Find the answers and clarification you need right here!
Features and Benefits
- Updated and NEW information on:
- Expanded guidance on observation
- Changes on charge reconciliation and auditing (NEW chapter)
- Audit tips and guidance on current RAC approved issues
- Step-by-step through coding and documentation for infusion and injection services in all care settings
- Comprehensive — covers a broad range of infusion/injection services, including hydration therapy, drug administration, injections and chemotherapeutic services, as well as blood collection, transfusions and other procedures; also includes a section on coding for drugs and biologicals
- Easy-to-understand overviews of coding systems, including ICD-10, modifiers, evaluation and management (E/M) services, medical necessity, local/national coverage determinations, audit targets and other critical topics
- Sections on specific services include:
- Descriptions of services with their corresponding current codes (CPT, HCPCS, revenue center) and descriptions
- Explanations of intended code use
- Documentation requirements
- Tables displaying time increments for reporting services, where applicable
- Examples of drugs involved
- Billing tips
- Guidance with coding and billing in alignment with the Medicare move to site-neutral payments
- Case studies and examples, updated with new payment changes, to reinforce best practices
- Chapter with payment tables for physicians and hospitals
- Special help with common areas of confusion and noncompliance, such as:
- Documentation related to time, route, site and flushes for timed codes
- Billing for E/M services — a major area of focus for the OIG, RACs and other auditors
- Comprehensive APC (c-APC), for observation care
CPT® is a registered trademark of the American Medical Association.
The final rules for the 2018 Medicare outpatient prospective payment system (OPPS) and the Medicare physician fee schedule (MPFS) dictate the publishing dates for our books. In previous years, the Centers for Medicare & Medicaid Services have issued these final rules in early November of the previous year (November 2017), and the updating process for our books begins.