How To Use CPT Code 6150F

CPT 6150F describes the situation where a patient with inflammatory bowel disease (IBD) is not receiving a first course of tumor necrosis factor (TNF) inhibitor therapy. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 6150F?

CPT 6150F can be used to indicate that a patient with inflammatory bowel disease (IBD) is not receiving a first course of tumor necrosis factor (TNF) inhibitor therapy. This code is used when the healthcare provider documents in the patient’s healthcare record that they are not receiving TNF inhibitor therapy.

2. Official Description

The official description of CPT code 6150F is: ‘Patient not receiving a first course of anti-TNF (tumor necrosis factor) therapy (IBD).’

3. Procedure

1. The healthcare provider assesses the patient’s condition and determines if they are receiving a first course of TNF inhibitor therapy.
2. If the patient is not receiving a first course of TNF inhibitor therapy, the healthcare provider documents this information in the patient’s healthcare record.

4. Qualifying circumstances

CPT 6150F is used for patients with inflammatory bowel disease (IBD) who are not receiving a first course of tumor necrosis factor (TNF) inhibitor therapy. Inflammatory bowel disease refers to a group of inflammatory conditions that primarily affect the small intestine and colon, such as ulcerative colitis and Crohn’s disease. TNF inhibitors are biologic drugs that reduce the immune response in patients with IBD when standard therapies are ineffective or not well tolerated. The long-term use of TNF inhibitors carries certain risks, such as an increased susceptibility to opportunistic diseases and reactivation of latent infections. The healthcare provider must document in the patient’s healthcare record that they are not receiving TNF inhibitor therapy.

5. When to use CPT code 6150F

CPT code 6150F should be used when the healthcare provider confirms that the patient with inflammatory bowel disease (IBD) is not receiving a first course of tumor necrosis factor (TNF) inhibitor therapy. This code should not be used if the patient is receiving a first course of TNF inhibitor therapy.

6. Documentation requirements

To support a claim for CPT code 6150F, the healthcare provider must document the following information:

• Confirmation that the patient has inflammatory bowel disease (IBD)
• Documentation that the patient is not receiving a first course of tumor necrosis factor (TNF) inhibitor therapy

7. Billing guidelines

When billing for CPT code 6150F, ensure that the healthcare provider has documented that the patient is not receiving a first course of TNF inhibitor therapy for their inflammatory bowel disease (IBD). This code should not be reported if the patient is receiving a first course of TNF inhibitor therapy. There are no specific guidelines regarding reporting CPT code 6150F with other codes.

8. Historical information

CPT code 6150F was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates to the code since its addition.

9. Examples

1. A patient with ulcerative colitis is not receiving a first course of TNF inhibitor therapy.
2. A patient with Crohn’s disease is not receiving a first course of TNF inhibitor therapy.
3. A patient with inflammatory bowel disease is not receiving a first course of TNF inhibitor therapy due to contraindications.
4. A patient with ulcerative colitis is not receiving a first course of TNF inhibitor therapy due to financial constraints.
5. A patient with Crohn’s disease is not receiving a first course of TNF inhibitor therapy because they prefer alternative treatment options.
6. A patient with inflammatory bowel disease is not receiving a first course of TNF inhibitor therapy due to concerns about potential side effects.
7. A patient with ulcerative colitis is not receiving a first course of TNF inhibitor therapy because they have achieved remission with other medications.
8. A patient with Crohn’s disease is not receiving a first course of TNF inhibitor therapy because they are participating in a clinical trial for a new treatment.
9. A patient with inflammatory bowel disease is not receiving a first course of TNF inhibitor therapy because they are pregnant and it is not recommended during pregnancy.
10. A patient with ulcerative colitis is not receiving a first course of TNF inhibitor therapy because they have opted for surgical intervention.