2005 Infusion and Injection G codes

In 2005 Physicians may now bill several infusion codes in one day for a single patient. 

Report (G0347) for an antibiotic infusion  AND (G0345) for a hydration infusion.

Report  (G0347) for one antibiotic  AND the infusion of a second drug concurrently (G0350) or sequentially (G0349).

If a combination of chemotherapy (monoclonal antibodies, biological response modifiers), non-chemotherapy drugs, and/or hydration is administered by infusion sequentially, the initial code that best describes the service should always be billed irrespective of the order in which the infusions occur.

As indicated above,  Add-On codes must be billed with other codes, and the CMS payment reflects the incremental resources associated with providing the additional service. 

For two  Add-On  codes (G0350, G0354), the table above has an "N/A" listed in the "Old CPT" column, meaning there were no CPT codes that existed explicitly for these services. These services will now be billable under the new coding system. 

Use code G0350 for a "concurrent infusion." A concurrent infusion refers to the simultaneous infusion of two non-chemotherapy drugs. 

Use code  G0354 for each additional sequential non-chemotherapy drug administered by IV push.

Physicians also may bill for an evaluation and management (E&M) service on the same day as an infusion, if a separate service was performed. Be sure to append modifier 25 to the E & M Code.

Services that were previously reported under CPT code 90781 (non-chemotherapy infusion, each additional hour) will be billed under one of four G-codes.

In 2005, if a second (or other subsequent) non-chemotherapy drug is administered sequentially, the physician would bill code 90781 for the additional hour of infusion.

Report G0349 for the sequential administration of a second or subsequent non-chemotherapy drug. 

Report G0360 for each additional hour of the infusion of anti-neoplastic agents for the treatment of non-cancer diagnoses or substances, such as monoclonal antibodies and other biological modifiers.

Under the new infusion coding structure, if a drug such as amphotericin is given and takes more than one hour to infuse, report G0347 for an initial one hour drug infusion and report G0348  Add-On for the subsequent hours of infusion. 

The codes for hydration (G0345 and G0346 in the table) are for reporting hydration intravenous (IV) infusions consisting of a prepackaged fluid and electrolytes. These codes are not used to report infusion of drugs or other substances.

Injections - G Codes
Under prior CPT codes (90782-90788) (therapeutic, prophylactic or diagnostic injections), payment for injections was bundled unless they were the only service billed by the physician for the patient that day.

This is no longer the case. The new G codes G0351 - G0354 may be separately paid even if another physician fee schedule service is billed for the same patient that day.

Injections that were previously billed under CPT code 90782 will now be billed under HCPCS code G0351. Physicians should continue to use CPT code 90783 for intra-arterial injections (this is incorrectly reported in the final rule, and CMS has said it will issue a clarification). 

Non-chemotherapy drugs administered by IV push (currently using CPT code 90784) should now be billed under HCPCS code G0353. The CPT book does not currently contain a code for physicians to bill a second (or other subsequent) non-chemotherapy drug administered by IV push. 

The CPT Editorial Panel created a new code for each additional non-chemotherapy drug administered by IV push. For 2005, the physician should bill HCPCS code G0354.

The CPT coding system will be deleting code 90788 (Intramuscular injection of antibiotic) in 2006. CMS is maintaining CPT code 90788 as an active code until it is changed in the CPT coding system and instructions are provided on the code to bill in its place beginning January 1, 2006.

 Add-On Codes 
CMS created the following new add-on G-codes: G0346, G0348, G0349, G0350, and G0354.

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