How To Use CPT Code 99602

CPT 99602 describes the home infusion/specialty drug administration services provided by a healthcare provider during a visit to the patient’s home. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 99602?

CPT 99602 can be used to describe the additional hours of home infusion/specialty drug administration services provided by a healthcare provider during a visit to the patient’s home. This code is used when the provider spends more than two hours administering the infusion or specialty drug to the patient.

2. Official Description

The official description of CPT code 99602 is: ‘Home infusion/specialty drug administration, per visit (up to 2 hours); each additional hour (List separately in addition to code for primary procedure).’ This code should be used in conjunction with CPT code 99601 for the first two hours of the visit.

3. Procedure

1. The healthcare provider prepares the infusion equipment or administration supplies at the patient’s home.
2. Using an intravenous line connected to a small mechanical pump, the provider administers the infusion or specialty drug at the prescribed rate for the prescribed length of time.
3. If the visit extends beyond two hours, the provider continues to administer the infusion or specialty drug for each additional hour.

4. Qualifying circumstances

Patients eligible to receive CPT 99602 services are those who require home infusion or specialty drug administration. This may include patients receiving peritoneal dialysis, intramuscular injections, or hemodialysis at home. The healthcare provider must visit the patient’s home to provide the services.

5. When to use CPT code 99602

CPT code 99602 should be used when a healthcare provider spends additional hours administering the infusion or specialty drug during a home visit. This code is used in addition to CPT code 99601, which covers the first two hours of the visit.

6. Documentation requirements

To support a claim for CPT 99602, the healthcare provider must document the following information:

• Reason for the home infusion or specialty drug administration
• Start and end time of the visit
• Duration of each additional hour beyond the first two hours
• Details of the infusion or specialty drug administered
• Progress made by the patient during the visit
• Signature of the healthcare provider

7. Billing guidelines

When billing for CPT 99602, ensure that the healthcare provider has already reported CPT code 99601 for the first two hours of the visit. This is an add-on code, and payers will not reimburse if it is reported without an appropriate primary code. It is important to follow the specific guidelines provided by the payer regarding the reporting of CPT 99602.

8. Historical information

CPT 99602 was added to the Current Procedural Terminology system on January 1, 2004. There have been changes to the code since its addition, including the addition of each additional hour as a separate listing on January 1, 2005.

9. Examples

1. A healthcare provider visits a patient’s home to administer a specialty drug for three hours.
2. During a home visit, a provider administers an infusion to a patient for four hours.
3. A healthcare provider spends an additional hour administering a specialty drug to a patient during a home visit that already lasted two hours.
4. For a home visit, a provider administers an infusion to a patient for five hours.
5. A healthcare provider spends three additional hours administering a specialty drug to a patient during a home visit.
6. During a home visit, a provider administers an infusion to a patient for six hours.
7. A healthcare provider spends two additional hours administering a specialty drug to a patient during a home visit.
8. For a home visit, a provider administers an infusion to a patient for seven hours.
9. A healthcare provider spends four additional hours administering a specialty drug to a patient during a home visit.
10. During a home visit, a provider administers an infusion to a patient for eight hours.