Certified Coding Specialist (CCS) Practice Exam

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What is the appropriate way to code chemotherapy administration for a 3-hour infusion?

96401, 96413, 96413

96413, 96415, 96415

In coding for chemotherapy administration, it is important to accurately reflect the services provided, including the duration and complexity of the infusion. For a 3-hour infusion of chemotherapy, the appropriate codes under the Current Procedural Terminology (CPT) guidelines would involve both the initial infusion and any subsequent infusions, as well as the specific codes designated for the service rendered. The coding sequence typically begins with the base code for the initial 1-hour infusion, followed by additional codes that correspond to the extra time required. In this case, because the infusion lasts for 3 hours, the code for the initial infusion (96413) is used, which accounts for the first hour of chemotherapy. The subsequent hours of infusion are denoted by the additional codes (96415), indicating each additional hour beyond the first. So, using the codes correctly represents the entire duration of the service provided: one code for the initial 1-hour infusion, followed by two codes for the additional 2 hours. This provides a complete and accurate representation of the chemotherapy administration and complies with coding guidelines that detail how to count additional durations of infusion. While other options might include various combinations of codes, they either fail to represent the correct duration or do not align with the standard coding practices

96413, 96415-51

96401

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