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The CPT® Code 96409 refers to the administration of chemotherapy through an intravenous push (IVP) technique, specifically for a single or initial chemotherapy substance or drug. This procedure is primarily utilized in the treatment of malignant neoplasms, which are cancerous tumors that can invade surrounding tissues and spread to other parts of the body. During this process, a specified chemotherapy agent is injected directly into the patient's bloodstream via a syringe. This injection can be performed through an existing intravenous line or an intermittent infusion set, commonly known as a saline lock. The administration of the chemotherapy substance is typically completed within a short duration, usually taking less than 15 minutes. It is important to note that for subsequent pushes of additional chemotherapy substances or drugs through the same venous access site, the add-on code 96411 should be utilized. This structured approach ensures that the treatment is delivered efficiently and effectively, adhering to the necessary protocols for chemotherapy administration.
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The procedure described by CPT® Code 96409 is indicated for the administration of chemotherapy in patients diagnosed with malignant neoplasms. The following conditions may warrant the use of this procedure:
The procedure for administering chemotherapy via intravenous push (IVP) using CPT® Code 96409 involves several key steps:
After the administration of chemotherapy using CPT® Code 96409, the patient may require specific post-procedure care. This includes continued monitoring for any delayed side effects or complications that may arise from the chemotherapy treatment. The healthcare provider may provide instructions regarding hydration, potential side effects to watch for, and follow-up appointments for further treatment or evaluation. It is essential to document the administration details, including the drug used, dosage, and the patient's response to the treatment, to ensure comprehensive care and compliance with medical coding standards.
| Short Descr | CHEMO IV PUSH SNGL DRUG | Medium Descr | CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG | Long Descr | Chemotherapy administration; intravenous, push technique, single or initial substance/drug | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 5 - Incident To Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Not Discounted when Multiple | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | P7B - Oncology - other | MUE | 1 | CCS Clinical Classification | 224 - Cancer chemotherapy |
This is a primary code that can be used with these additional add-on codes.
| 0663T | Add-on Code MPFS Status: Carrier Priced APC N Scalp cooling, mechanical; placement of device, monitoring, and removal of device (List separately in addition to code for primary procedure) | 96361 | Addon Code MPFS Status: Active Code APC S CPT Assistant Article Intravenous infusion, hydration; each additional hour (List separately in addition to code for primary procedure) | 96367 | Addon Code MPFS Status: Active Code APC S CPT Assistant Article Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); additional sequential infusion of a new drug/substance, up to 1 hour (List separately in addition to code for primary procedure) | 96375 | Addon Code MPFS Status: Active Code APC S CPT Assistant Article Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure) | 96376 | Addon Code MPFS Status: Statutory exclusion (from MPFS, may be paid under other methodologies) APC N CPT Assistant Article 1Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure) | 96411 | Addon Code MPFS Status: Active Code APC S Physician Quality Reporting PUB 100 CPT Assistant Article Chemotherapy administration; intravenous, push technique, each additional substance/drug (List separately in addition to code for primary procedure) |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | X2 | Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | JZ | Zero drug amount discarded/not administered to any patient | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | Q5 | Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner |
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| 2011-01-01 | Changed | Short description changed. |
| 2006-01-01 | Added | First appearance in code book in 2006. |