2025 CPT code 96401
(Active) Effective Date: N/A Medicine - Chemotherapy administration Feed
Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic.
Modifiers may be applicable. Refer to current CPT guidelines for appropriate usage.
Medical necessity for chemotherapy administration should be supported by documentation of the patient's diagnosis, treatment plan, and expected benefits of the therapy.
The provider discusses the risks, benefits, and potential side effects of chemotherapy with the patient, obtains informed consent, and administers the non-hormonal, antineoplastic drugs subcutaneously or intramuscularly.
In simple words: The healthcare provider injects non-hormonal cancer-fighting drugs under the skin or into the muscle.
Administration of non-hormonal, antineoplastic chemotherapy drugs via subcutaneous or intramuscular routes. This includes nonradionuclide antineoplastic drugs, monoclonal antibody agents and other biologic response modifiers, and other antineoplastic agents, excluding hormonal drugs.
Example 1: A patient with lung cancer receives a subcutaneous injection of nivolumab., A patient with lymphoma receives an intramuscular injection of rituximab., A patient with multiple myeloma receives a subcutaneous injection of daratumumab.
Documentation should include the drug administered, dosage, route of administration, date and time of administration, and any observed side effects. Informed consent should also be documented.
** It is important to distinguish between the administration of chemotherapy and other therapeutic injections. This code is specifically for chemotherapy and related highly complex drug or biologic agents, which require a higher level of monitoring and oversight due to the potential for severe adverse reactions.
- Specialties:Oncology, Hematology
- Place of Service:Office, Outpatient Hospital, Clinic