Bringing Clarity to Complex Coding and Billing Rules for Infusion Services

How do you help healthcare providers make sense of the complicated rules that govern coding and billing for infusion and injection services? Easy! You arm them with resources that use plain English and at-a-glance tools to convey must-know information, from the documentation requirements for timed services to the coding and billing of COVID-19 therapeutic infusions and injections.

Well, maybe easier said than done.

Fortunately, MedLearn Publishing possesses a “secret weapon” — a deep pool of expertise to assemble the industry’s most comprehensive and coherent resources for infusion/injection coding and billing. A primary contributor to these resources for the past six years has been Tiffani Bouchard, CCS.

Leveraging her extensive drug administration coding background, Tiffani plays a key role in the yearly updates to our Coding Essentials for Infusion & Injection Therapy Services publication. She’s also a co-presenter of our webcasts on infusion/injection services, including our annual Reimbursement & Compliance Update. We asked Tiffani about what goes into these resources and why she thinks they stand out from the crowd.

Highlights of Tiffani Bouchard’s comments…

Areas of confusion and noncompliance: During the past several years, we’ve observed many significant problem areas in infusion coding and billing. One big issue is missing infusion start and stop times for hydration therapy, among a number of documentation deficiencies. Another common area of noncompliance is incorrect code selection for drug administration — an area with constant change. These and other miscues have made infusion/injection services a favorite target of Recovery Audit Contractors (RACs).

MedLearn Publishing’s approach: MedLearn infusion resources provide really good guidance through the coding, documentation, and billing of infusion/injection services. Unlike other resources on the market, we use lay terms that can be easily understood by someone who’s new to the industry. But we also speak to those who are more experienced. In other words, we accommodate the wide range of knowledge among users of our resources.

Favorite attributes: Looking at the Coding Essentials book, I think its biggest strength is that it consolidates many resources into one place, saving customers the time and confusion of having to navigate multiple resources. And the information we provide is truly actionable, whether it’s selecting the correct drug administration code or ensuring that documentation is complete and compliant. We even include tips for conducting internal audits, to make certain claims are appropriate based on the documentation.

The payoff: So much can go wrong with coding and billing in this area of medicine. For example, we see a lot of confusion around coding hierarchies (e.g., infusion vs. IV push codes), and this may lead to selecting the wrong initial charge. Given the high volume of infusion/injection services, users of these resources could easily offset their costs by avoiding just one instance of noncompliance.

Why use the most current resources? Especially with new drugs constantly coming on the market, coding and billing guidelines for infusion and injection services are undergoing continuous change. We’re always monitoring official sources and making sure we incorporate anything new into our infusion/injection resources. In the case of the book, we also make enhancements based on user feedback, so it’s even more informative, clear, concise and easier to use. Our webcasts provide an excellent opportunity to get updated on the very latest developments and get answers to questions from subject matter experts. Nobody else does all this!

Click here for more information about MedLearn Publishing infusion and injection resources.