This page addresses follow-up questions and additional information pertinent to our webinar
Complex Injections and Infusions – Shoot For the Moon!.

** The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic as they can change rapidly.

Q: Where do intra-arterial medication administrations fall into the hierarchy?
A: If an intra-arterial medication is given, it falls into the same category as intravenous injections, with infusions taking precedence over pushes.

Q: Can we add codes and bill for supplemental procedures that go along with injections and infusions, such as injection of anesthesia, performing a heparin flush, or special monitoring after an injection or infusion?
A: Numerous services are already included in the infusion charge. Services that are included in the infusion charge are use of local anesthesia, time preparing the drug/prepping the patient, starting the IV, accessing the port, flushing the line before and after the administration, monitoring patient after infusion, and educating the patient.

Q: Should physicians also be coding and billing for these services if they perform them?
A: As stated in the AMA CPT Manual, infusion and injection services within the CPT code range of 96360-96425 and 96521-96523 are not intended to be reported by the physician even in the facility setting. Instead, physicians should select the most appropriate E/M service.

Q: Chemotherapy administration into the pleural cavity and peritoneal space were mentioned during the webinar, but not really discussed further. What types of conditions do these administrations treat, and how are they administered?
A: Intrapleural chemotherapy normally coincides with surgical treatment for removal of pleural malignancies like mesothelioma or malignant pleural effusion. The aim is to treat small or microscopic cancer cells that may have been left behind. A catheter is placed directly into the pleural space for administration. Intraperitoneal chemotherapy is similar, except it is administered directly into the peritoneal space instead of the pleural space. It is especially effective for treatment of peritoneal cancers, and liver or pancreatic cancer. Similarly to intrathecal chemo administration, both intrapleural and intraperitoneal chemotherapy can be used in higher doses since they are not circulating throughout the rest of the body.