Question

Patient has lupus and is coming into the office for their solu-medrol infusion therapy (80 mg)....

Patient has lupus and is coming into the office for their solu-medrol infusion therapy (80 mg). The nurse documents start time at 10:45 am end time of 12:30 pm. How is this billed?

1) 96365, 96366, J2939
2) 96365, J2930
3) 93635, 96367, J2920 x 2
4) 96365, 96370, J2930

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Answer #1

This is billed like  93635, 96367, J2920 x 2.

This is because CPT Code 93635 represents Intravenous infusion for therapy upto 1 hours.

J2920 represents infusion of methylprednisolone sodium succinate, up to 40 mg. That means 2 times of J2920 indicates 80mg of solu-medrol is administered.

Since, the nurse documents start time at 10:45 am and end time of 12:30 pm it means the therapy lasted for more than one hours.

Therefore, 96367 represents additional sequential infusion up to 1 hours.

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