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2025 HCPCS code S9325

Home infusion therapy for pain management; includes administrative, pharmacy, and coordination services, supplies, and equipment (excluding drugs and nursing visits).

This code should only be used for daily home infusion therapy for pain management.Do not use this code if continuous (S9326), intermittent (S9327), or infusion pump (S9328) infusion therapy is used.Drugs and nursing services must be separately coded.

Medical necessity for S9325 is established when the patient requires home infusion therapy for pain management due to a medical condition that necessitates this type of administration. The treatment must be deemed appropriate and necessary to manage the patient's pain and improve quality of life. Supporting documentation is essential to demonstrate that the therapy is medically necessary and the most appropriate treatment option available. This may involve evidence such as physician orders, patient assessment, treatment plan, and documentation of the patient's response.

The clinical responsibility involves overseeing and coordinating all aspects of the home infusion therapy for pain management, including administrative tasks, pharmacy services, care coordination, and ensuring the availability of necessary supplies and equipment. The physician or other qualified healthcare professional is responsible for ordering the therapy, monitoring the patient's response, and making adjustments as needed. They are not directly responsible for the infusion administration itself, as that is typically performed by qualified nurses or home infusion therapy personnel.

IMPORTANT:Do not use with HCPCS codes S9326, S9327, or S9328.

In simple words: This code covers the services involved in giving pain medicine through a catheter at home each day.It includes planning, pharmacy work, and making sure everything works smoothly. However, the cost of the medicine itself and nurse visits are billed separately.

This HCPCS code, S9325, encompasses daily home infusion therapy services for pain management.It includes administrative services, professional pharmacy services, care coordination, and all medically necessary supplies and equipment.Drugs and nursing visits are billed separately. This code is not to be used with HCPCS codes S9326, S9327, or S9328.

Example 1: A patient with chronic back pain receives daily home infusion therapy for pain management.The S9325 code is used to bill for the administrative, pharmacy, coordination, and supply aspects of this service. The medication and nursing visits are separately billed., A patient who recently underwent major abdominal surgery experiences significant postoperative pain. Daily home infusion therapy using S9325 is implemented to manage pain effectively while the patient recovers at home. Again, medication and nursing care are billed using different codes., A patient with end-stage cancer requires palliative home infusion therapy for pain control. S9325 covers the various services associated with administering this therapy in the home setting. Medications and direct nursing care are documented and billed separately.

Detailed documentation must support medical necessity, including the patient's diagnosis, pain assessment, treatment plan, medication details, infusion schedule, and supplies used.Records should show the coordination of care and services provided by different professionals involved.Notes regarding patient response and any adjustments to the therapy must also be included.

** This code is not reimbursable by Medicare.It is primarily used by private payers and Medicaid programs.Home infusion therapy providers must have a separate National Provider Identifier (NPI) and a signed participation agreement.

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