General Question for the Week of February 27, 2023

Question:

Can we separately report codes 96360 and 96361 for CAR-T?

Answer:

The fluid used to administer the cells and other infusions for incidental hydration (e.g., 96360, 96361) are not reported separately. Similarly, infusion(s) of any supportive medication(s) (e.g., steroids) concurrently with the CAR-T cell administration are not reported separately. However, hydration or administration of medications (e.g., antibiotics, opioids) unrelated to the CAR-T administration may be reported separately with modifier 59. Understand, it is common for lymphodepleting (LD) chemotherapy (e.g., Bendamustine, Fludarabine, and Cyclophosphamide) to be added to the patient’s treatment plan. This form of chemotherapy is usually performed days before the infusion of the CAR-T cells. The chemotherapy drugs administered may be reported with applicable chemotherapy drug administration codes on the date they were performed.

This question was answered in our Coding Essentials for Infusion & Injection Therapy Services. For more hot topics relating to infusion services, please visit our store or call us at 1.800.252.1578, ext. 2.