Coding Essentials for Infusion & Injection Therapy Services

Much more than a coding resource…a guide to the full, compliant payment

Is your documentation missing critical start and stop times for infusions? Are there medical necessity issues with your hydration therapy services? Which coding and billing missteps for drug administration are auditors targeting? These are just a few of the many scenarios that threaten infusion and injection service compliance and revenues nationwide, year after year.

When you’re equipped with the right resource, these high-risk situations are also highly avoidable. As its name implies, our Coding Essentials for Infusion & Injection Therapy Services provides clear-cut guidance through coding for a full range of infusion and injection services in all settings. But it also tackles the recurring issues and challenges that put your payments and compliance at risk, from missing crucial elements in documentation, to confusion surrounding current payer trends.

Our book delivers everything you need, starting with clear authoritative guidance from the American Medical Association (AMA) and Centers for Medicare & Medicaid Services (CMS), supplemented by plain-English explanations, quick tips, answers to FAQs, case examples and other tools. Our ultimate goal is to help you capture — and keep — the full, compliant payment for these high-volume services.

Features and Benefits

Updated and expanded content, including:

• COVID-19 update highlighting documentation requirements, plus coding and billing for therapeutic infusions and injections.
• Coverage of all changes pertaining to infusion and injection therapy services, including updated Outpatient Prospective Payment System (OPPS) rates, status indicators and APCs
• Guidance to ensure proper implementation and coordination between departments when mid-year changes are released
• Tactics for preventing high-risk practices and auditor takebacks
• Detailed instruction through coding hierarchies
• Expanded guidance with payer issues and challenges related to drug administration and other infusion services

Our experts address common questions, concerns, and problem areas:

• Documentation related to time, route, site and flushes for timed codes
• "White bagging" and "brown bagging" drug supplies, including documentation and modifier requirements
• The impact of smart pumps and other technologies on documentation
• Comprehensive APC (C-APC), for observation care
• Coding and billing in alignment with the Medicare move to site-neutral payments

Clear, step-by-step guidance through the tasks you perform every day:

• Coding and documentation for infusion and injection services in all care settings
• Covers a broad range of infusion/injection services, including hydration therapy, drug administration, injections and chemotherapy services, as well as blood collection, transfusions and other procedures; also includes a section on coding for drugs and biologicals

A proven quick-reference approach for busy professionals:

• Coding index that quickly identifies pages in the book for specific drug administration codes
• 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
• Case studies, answers to FAQs reflecting common and complex challenges faced by professionals across the country, and case examples, to reinforce best practices and provide a concrete breakdown of problem areas
• Chapter with payment tables for physicians and hospitals