Pharmacy

Pharmacy Question for the Week of August 12, 2019

Pharmacy Compliance Question of the Week

Question:

What are the impacted codes for the RAC audit involving therapeutic injections and infusions?

Answer:

For the “Therapeutic, Prophylactic, and Diagnostic Injections and Infusions: Documentation Requirements” audit, the codes targeted will be 96365 and 96366.

96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)