How To Use CPT Code 96409

CPT 96409 describes the administration of chemotherapy using an intravenous push technique for a single or initial drug. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 96409?

CPT 96409 is used to describe the administration of chemotherapy drugs using an intravenous push technique. This code is specifically used when the provider administers a single or initial drug through an IV push, typically lasting for 15 minutes or less. The advantage of using this technique is that the drug can have an immediate effect as it is injected directly into the bloodstream.

2. Official Description

The official description of CPT code 96409 is: ‘Chemotherapy administration; intravenous, push technique, single or initial substance/drug.’

3. Procedure

1. The provider connects the syringe containing the chemotherapy drug to the patient’s IV access device.
2. The provider slowly injects the drug into the patient’s bloodstream using an intravenous push technique.
3. The provider administers a single or initial drug for infusion, typically lasting for 15 minutes or less.
4. If continuous presence of the provider is required for administration and observation, it is also considered a push.

4. Qualifying circumstances

CPT 96409 is used when the provider administers chemotherapy drugs using an intravenous push technique. This procedure is typically performed to treat diseases, especially cancer, by killing fast-growing cells in the body. The administration of a single or initial drug through an IV push qualifies for this code.

5. When to use CPT code 96409

CPT code 96409 should be used when the provider administers a single or initial chemotherapy drug using an intravenous push technique. This code is appropriate for drugs that are infused for 15 minutes or less. If the provider administers a drug or substance through IV push technique, other than the initial drug or substance, CPT code 96411 should be used.

6. Documentation requirements

To support a claim for CPT 96409, the provider must document the following information:

• The specific chemotherapy drug administered
• The use of an intravenous push technique
• The duration of the infusion, which should be 15 minutes or less
• Any additional relevant details about the administration process

7. Billing guidelines

When billing for CPT 96409, ensure that the administration is performed using an intravenous push technique for a single or initial drug. It is important to note that CPT code 96409 should not be reported if other codes, such as CPT codes 96411 to 96417, have already been performed in the previous seven days. Additionally, consider the location of the testing when coding pulmonary function tests (PFTs) as they have both a professional and technical component.

8. Historical information

CPT 96409 was added to the Current Procedural Terminology system on January 1, 2006. There have been no updates to the code since its addition.

9. Examples

1. A provider administers a single chemotherapy drug using an intravenous push technique for a patient with breast cancer.
2. A patient receives the initial dose of chemotherapy through an IV push for the treatment of lymphoma.
3. A provider administers a single drug using an intravenous push technique for a patient with lung cancer.
4. A chemotherapy drug is administered through an IV push for a patient with leukemia.
5. The initial dose of chemotherapy is given through an intravenous push for a patient with colon cancer.
6. A provider administers a single drug using an intravenous push technique for a patient with ovarian cancer.
7. A patient receives the first dose of chemotherapy through an IV push for the treatment of pancreatic cancer.
8. A provider administers a single drug using an intravenous push technique for a patient with prostate cancer.
9. The initial dose of chemotherapy is given through an intravenous push for a patient with melanoma.
10. A provider administers a single drug using an intravenous push technique for a patient with sarcoma.