An observation pt had a rocephin infusion on 2/20 from 2255 – 2324 and then 2 more rocephin infusions on 2/21 from 0507 -0537 and 1040 – 1110.

We are trying to figure out how to correctly code the subsequent infusions of the same drug that were not more than 30 minutes. CPT description for 96366 states 30 minutes or more.

They cannot be a push since they were more than 15 minutes.

CPT book section instructions for 96365-96371 has an includes note that states includes an infusion of 16 minutes or more.

CPT Asst Sept 2018 Frequently Asked Questions page 15 – states that second and subsequent infusions should be reported based on the individual times of each additional infusion of the same drug/substance using the appropriate add-on code.

Coding Clinic 2018 Third Qtr gives an example of a patient that has an infusion for 1 hour and 30 minutes. It says that since the additional time does not meet the required 31 minutes or more and it does not meet the requirements of a push, the additional 30 minutes is not coded.

Can you please help us come to a conclusion on how to code the additional infusions?

Thanks so much!