Infusions using portable pumps less than 8 hours
What would be the appropriate drug administration CPT to code to use when a non-chemo drug is administered via an Eclipse pump. These are elastomeric pumps that can provide safe continuous infusion for 15 minutes up to 5 hours. Typically in our setting it is used for infusions of 30 minutes up to 2 hours. The RN connects the Eclipse device to the patient IV access and the patient may then leave once infusion begins. The device is disposable so there is no need for patient to return. Since patient is not present on infusion completion, there is no stop time documentation. Also the infusion using this device does not last for more than 8 hours, so 96416 or C8957 is not applicable. Is this an unlisted code or would a push code be allowable since there is documentation of administering a medication intravenously?
Comments
Based on CPT guidelines, timed services are billed based on the time involved by the provider. Based on the scenario that you describe, there would not be documentation of the RN actually pushing the drug, and unless the RN is monitoring the patient as they would for a typical infusion, you don't have support for the infusion codes. I would be sure that the documentation by the RN includes assessment of an existing IV site or starting a new IV site, blood return, etc., education of the patient regarding any issues with the infusion, how to disconnect, etc. Based on the codes and guidelines available, it seems that the unlisted code is the only option. I would also work with the manufacturer to request a HCPCS code that describes an infusion of less than 8 hours that involves a disposable (or reusable) pump in order to better represent the service being provided.