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Infusion Billing Quiz

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Do you have what it takes to bill the perfect claim?

Join Mary on oher culinary adventure as she dives into the world of infusion therapy billing! Mary is eager to learn, but she needs your help to cook up the perfect burger while mastering the ins and outs of billing infusion therapy. Can you guide her through four challenging scenarios? Each correct answer bring s a smile to Mary, while wrong choices leave her feeling a bit down. Are you ready to chop, saute, and bill your way to success? Let's get cooking!

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This is Sally. Sally has recently been diagnosed with bone cancer and has received an order to commence eight rounds of chemotherapy treatment.

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Claim #1

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1/6

Which HCPC would Mary use to bill for the initial visit chemotherapy?

G0088

G0089

G0090

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2/6

For Sally first visit she was on the machine for a total of 2 hours and 15 minutes. How many units should Mary bill for?

8

9

10

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3/6

During Sally's chemotherapy, a second order for an iron infusion is placed. What modifier should be billed with 96365 for the iron infusion?

SH, KX

SJ, KX

KX

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The first patient's claim is ready to bill, and your burger is halfway cooked! Keep it up! Let's work on another claim to complete the burger and serve it to perfection.

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Excellent work!

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This is Paul. Paul has been receiving pain management for three weeks, now on his fourth visit infusion therapy. Due to a stomach wound infection, his antibiotics cause digestive issues, so he uses Infusion Therapy for his pain medication and enteral nutrition.

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Claim #2

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4/6

What HCPCS Code should be billed for Paul's fourth visit of Pain Management IV Therapy?

G0088

G0068

G0069

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5/6

Paul was on the machine for a total of 85 minutes how many units should be billed.

5

6

7

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6/6

Paul receives enterals during his treatment, which help reduce the nausea he experiences. What modifier should be used with the CPT code A9270?

KX

GA

GY

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You've built the full burger and successfully billed the second claim! Now let's complete the order with some fries and a drink.

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Outstanding!

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This is Christina, who serves as the caregiver for her elderly mother, who is currently enrolled in a Medicare Dual Plan. Her mother's health is deteriorating, and currently is refusing to eat and does not have a peg tube.Christina wishes for her mother to receive enteral nutrition. Per the LCD policy Medicare will not pay for enterals that are taken orally.

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Claim #3

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Which modifier should be billed alongside the the HCPCS for the non-covered oral enterals?

KX

GY

BO

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A claim was billed for an orthotics device but was denied by Medicare as not medically necessary. What documentation is necessary to ensure the provider can still receive payment for this item?

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Claim #4

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ABN

ANN

BAN

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What documentation is needed for a non-medically necessary item if a patient has Medicare?

You have finished preparing the order.It's time to eat!

Quiz finished!

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