This resource provides information from a complex and evolving medical coding system. The treating physician is solely responsible for diagnosis coding and determination of the appropriate ICD-9-CM codes that describe the patient’s condition and are supported by the medical record. All codes listed in this guide are for informational purposes and are not an exhaustive list. The CPT, HCPS, and ICD-9-CM codes provided are based on AMA or CMS guidelines. The billing party is solely responsible for coding of services (eg, CPT coding). Because government and other third-party payor coding requirements change periodically, please verify current coding requirements directly with the payor being billed.
HCPCS |
| Code |
Description |
| A-4221 |
Infusion sets and needed supplies |
| C-9399 |
Unclassified drugs or biologicals (OPPS Hospitals only) |
| E-0779 |
Non-electric syringe pump |
| E-0781 |
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient. (*Medicare reimbursement at E0779 rate for Vivaglobin therapy.) |
| E-0791 |
Parenteral infusion pump, stationary, single or multichannel (*Medicare reimbursement at E0779 rate for Vivaglobin therapy.) |
| J-0256 |
Injection, alpha1–proteinase inhibitor, human, 10 mg |
| J-0850 |
Injection, cytomegalovirus immune globulin intravenous (human), per vial |
| J-1459 |
Injection, immune Globulin (Privigen®) per 500 mg - effective 1/1/2009 |
| J-1562 |
Injection, immune Globulin (Vivaglobin®), per 100mg |
| J-1566 |
Injection, immune globulin, lyophilized, per 500mg |
| J-2791 |
Rhophylac® Injection per 100 IU |
| J-3490 |
Unclassified drugs |
| J-3590 |
Unclassified biologics |
| J-7187 |
Injection, von Willebrand factor complex (Humate P®), per IU VWF:RCO |
| J-7190 |
Factor VIII (antihemophilic factor (human)), per IU |
| J-7192 |
Factor VIII (antihemophilic factor (recombinant)), per IU |
| J-7193 |
Factor IX (antihemophilic factor, purified, non-recombinant) per
IU |
| K-0552 |
Syringe |
| P-9041 |
Infusion, albumin (human), 5%, 50 mL |
| P-9045 |
Infusion, albumin (human), 5%, 250 mL |
| P-9046 |
Infusion, albumin (human), 25%, 20 mL |
| P-9047 |
Infusion, albumin (human), 25%, 50 mL |
CPT
|
| Code |
Description |
| 96365 |
Intravenous infusion for therapy, prophylaxis, or diagnosis (specify
substance or drug); initial, up to 1 hour |
| 96366 |
Each additional hour |
| 96367 |
Additional sequential infusion, up to 1 hour |
| 96369 |
Subcutaneous infusion for therapy or prophylaxis (specify drug) initial, up to one hour, including pump set-up and establishment of subcutaneous infusion sites |
| 96370 |
Subcutaneous infusion - each additional hour (list separately in addition to code for primary procedure) |
| 96371 |
Additional pump set up with establishment of new subcutaneous infusion site(s). (List separately in addition to code for primary procedure.)
(Use 90769 and 90771 only once per encounter) |
| 96372 |
Therapeutic, prophylactic or diagnostic injection (specify drug or
substance); subcutaneous or intramuscular |
| 96374 |
Intravenous push, single or initial substance/drug |
| 96375 |
Each additional sequential intravenous push of a new substance/drug |
| 96376 |
Each additional sequential intravenous push of the same substance/drug provided in a facility |
| 96379 |
Unlisted therapeutic prophylactic, or diagnostic intravenous or intra-arterial injection or infusion |
| 96521 |
Refilling and maintenance of portable pump |
| 96522 |
Refilling and maintenance of implantable pump or reservoir for drug
delivery, systemic (e.g., intravenous, intra-arterial) (Hospital
Outpatient only) |
| 96523 |
Irrigation of implanted venous access device for drug delivery systems
(Hospital Outpatient only) |
| 99070 |
Supplies and materials (except spectacles), provided by the physician
over and above those usually included with the office visit or other
services rendered (list drugs, trays, supplies, or materials
provided) |
| 99080 |
Special reports such as insurance forms, more than the information
conveyed in the usual medical communications or standard reporting
form |
ICD-9-CM |
| Code |
Description |
| 287.3 |
Idiopathic Thrombocytopenia Purpura |
| 286.0 |
Congenital factor VIII disorder |
| 286.1 |
Congenital factor IX disorder |
| 286.4 |
von Willebrand disease |
| 279.00 |
Hypogammaglobulinemia |
| 279.01 |
Selective IgA Immunodeficiency |
| 279.02 |
Selective IgM Immunodeficiency |
| 279.03 |
Other Selective Immunodeficiencies |
| 279.04 |
Agammaglobulinemia (X-Linked Bruton's Disease) |
| 279.05 |
Immunodeficiency with increased IgM |
| 279.12 |
Wiskott-Aldrich Syndrome |
| 279.2 |
Severe Combined Immunodeficiency |
| 279.06 |
Common Variable Immunodeficiency |
| 277.6 |
Other deficiencies of circulating
enzymes
alpha1–antitrypsin
deficiency |
| 286.3 |
Congenital deficiency of other clotting factors
|
| 286.9 |
Other unspecified coagulation defect
|
| 773.0 |
Hemolytic Disease due to Rh Isoimmunization |