Medicare

Under what circumstances does Medicare provide coverage for drugs or biologicals, and how is the determination made regarding whether a drug is considered “not usually self-administered”?

How should the administration of an IV infusion lasting longer than 1 hour but less than 91 minutes be reported? At what point should the code 96415 be used for “each additional hour” of infusion?

How should the administration of an IV infusion lasting longer than 1 hour but less than 91 minutes be reported? At what point should the code 96415 be used for “each additional hour” of infusion?

Will reporting codes 96372 and 96373 be impacted by the determination of the primary or secondary intent of the encounter?

What criteria must be met when using 96374 with 96375?

What codes do we report for monoclonal antibody Beyfortus™?

What factors should be documented when determining whether an antineoplastic agent is being administered for cancer or another cause?

From a claims perspective, what are some red flags when reviewing infusion and injection claims?

Why can’t we code 95180 (rapid desensitization) and chemotherapy drug administration codes together when we perform carboplatin desensitization?