How To Use CPT Code 96417

CPT 96417 describes the administration of a different chemotherapy drug through intravenous infusion following the administration of a primary dose of chemotherapy. 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 96417?

CPT 96417 can be used to report the administration of a different chemotherapy drug through intravenous infusion after the initial administration of a primary dose of chemotherapy. This code is an add-on procedure and should be reported in conjunction with the primary code for the initial administration of the chemotherapeutic drug.

2. Official Description

The official description of CPT code 96417 is: ‘Chemotherapy administration, intravenous infusion technique; each additional sequential infusion (different substance/drug), up to 1 hour (List separately in addition to code for primary procedure).’ This code should be used when a different chemotherapy drug is administered through intravenous infusion following the initial administration of a primary dose of chemotherapy.

3. Procedure

1. After the initial administration of a primary dose of chemotherapy, the healthcare provider continues the administration of a different chemotherapy drug through intravenous infusion.
2. The provider inserts a peripheral cannula or catheter into a peripheral vein and connects it to the chemotherapy agent.
3. The drug is administered into the vein at a slow and constant rate over a period of up to 1 hour.
4. The provider monitors the patient during the infusion to ensure proper administration and to address any potential adverse reactions.
5. After the infusion is complete, the provider removes the catheter or cannula from the patient’s vein.

4. Qualifying circumstances

CPT 96417 is used when a different chemotherapy drug is administered through intravenous infusion following the initial administration of a primary dose of chemotherapy. This code should only be reported if the primary code for the initial administration of the chemotherapeutic drug (such as CPT code 96413) is also reported. The additional drug administered must be different from the primary drug, and the infusion must last up to 1 hour.

5. When to use CPT code 96417

CPT code 96417 should be used when a different chemotherapy drug is administered through intravenous infusion following the initial administration of a primary dose of chemotherapy. This code should only be reported if the primary code for the initial administration of the chemotherapeutic drug is also reported. It is important to note that this code is an add-on procedure and should not be reported without the appropriate primary code.

6. Documentation requirements

To support a claim for CPT code 96417, the healthcare provider must document the following information:

• The primary code for the initial administration of the chemotherapeutic drug
• The specific different chemotherapy drug administered through intravenous infusion
• The date and duration of the infusion
• Any adverse reactions or complications during the infusion
• The removal of the catheter or cannula after the infusion
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 96417, ensure that the primary code for the initial administration of the chemotherapeutic drug is also reported. This code should only be reported if the additional drug administered is different from the primary drug, and the infusion lasts up to 1 hour. It is important to note that this code is an add-on procedure and should not be reported without the appropriate primary code.

8. Historical information

CPT code 96417 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 patient receives an initial dose of chemotherapy through intravenous infusion for one hour. After the initial dose, a different chemotherapy drug is administered through intravenous infusion for an additional hour.
2. Following the administration of the primary chemotherapeutic drug, a patient receives a different chemotherapy drug through intravenous infusion for up to 1 hour.
3. During a chemotherapy session, the provider administers the primary drug through intravenous infusion for one hour. Afterward, a different chemotherapy drug is administered through intravenous infusion for an additional hour.
4. After the initial administration of a chemotherapeutic drug, the provider administers a different drug through intravenous infusion for up to 1 hour.
5. A patient receives an initial dose of chemotherapy through intravenous infusion for one hour. Following the initial dose, a different chemotherapy drug is administered through intravenous infusion for an additional hour.
6. During a chemotherapy session, the provider administers the primary drug through intravenous infusion for one hour. Afterward, a different chemotherapy drug is administered through intravenous infusion for up to 1 hour.
7. After the initial administration of a chemotherapeutic drug, the provider administers a different drug through intravenous infusion for up to 1 hour.
8. A patient receives an initial dose of chemotherapy through intravenous infusion for one hour. Following the initial dose, a different chemotherapy drug is administered through intravenous infusion for an additional hour.
9. During a chemotherapy session, the provider administers the primary drug through intravenous infusion for one hour. Afterward, a different chemotherapy drug is administered through intravenous infusion for up to 1 hour.
10. After the initial administration of a chemotherapeutic drug, the provider administers a different drug through intravenous infusion for up to 1 hour.