Outpatient and Home Infusion Therapy: List of Codes

1 Outpatient InfusionsDescriptionCodeMedicare Will not payAntibioticsOffice Visit -25E/MInfusion SuppliesA4222X1st hr inf90765 Addl hr(s) inf90766 Infusion Sequential90767 Infusion , Concurrent90768 Drug(s) list separatelyHCPCS code (s)Chemo DrugsOffice Visit -25E/MMonoclonal antibody agentsInfusion suppliesA4222 XThis includes:Hydration Inf90760 RemicadeAddl hr(s) hydration90761 TysabriInfusion, sequential90767 Infusion , concurrent907681st hr chemo inf96413 Addl hrs(s) chemo inf964151st IV push90774 Addl IV push(s)90775 Drug(s) list separatelyHCPCS code (s)IVIGO ffice Visit -25E/MInfusion SuppliesA4222 XAdd on codeG03321st hour inf90765 Addl hr(s) inf 90766IV Push (usually not done)90775 Drug(s) list separatelyHCPCS code (s)MISCP rolonged services -up to 1hr99358 With some insurance carriers, you will need to add modifier -59 to the pushes and/or Infusion supplies InfusionsDescriptionHCPCS CodeMedicare Will not pay*IV AntiobioticEvery 3 hoursS9497 XIV AntiobioticEvery 24 hoursS9500 XIV AntiobioticEvery 12 hoursS9501 XIV AntiobioticEvery 8 hoursS9502 XIV AntiobioticEvery 6 hoursS9503 XIV AntiobioticEvery 4 hoursS9504X**Modifers to be added for 2nd SH2nd antibioticX& 3rd drugSJ3rd antibioticX* home Infusion therapy , antibiotic, antiviral, or antifungal therapy ; administrative services , professionalpharmacy services , care coordination, and all necessary supplies and equipment (drugs and nursingvisits coded separately), per diem.

2 ** Modifiers added to indicate the second and third drugs, if indicated. Typically the second drug isbilled out at half the standard per diem charge and the third is billed out at one-fourth of the standardper diem charge. The drug/nurse visit charges/reimbursement is not affected by the per diems. Alwaysbill the more frequent per diem first as the reimbursement will be higher for this code . For example:Merrem 1gm every 8 hours & Vancomycin 1gm every 12 hours would be billed like this for one day:S9502 X 1 (day)J2185 X 30 (units) = 3 dosesS9501-SH X 1 (day) {half per diem}J3370 X 4 (units) = 2 dosesOutpatient and home Infusion therapy : List of Codes