2025 CPT code 96422

Chemotherapy administration, intra-arterial; infusion technique, up to 1 hour.

Refer to the CPT® manual and payer-specific guidelines for detailed coding instructions.Appropriate modifiers (e.g., 59 for distinct procedural service) may be needed in certain situations.

Modifiers such as 59 (distinct procedural service) might be applicable depending on the circumstances of the service. The use of modifiers should be based on the circumstances of the individual case and should be carefully considered in light of the guidelines.

Medical necessity is established when intra-arterial chemotherapy offers a superior therapeutic advantage compared to systemic chemotherapy, such as in cases of localized tumors not amenable to surgical resection or radiotherapy, or when systemic administration might result in excessive systemic toxicity.

The clinical responsibility includes the physician's or qualified healthcare professional's oversight of the entire procedure, including patient assessment, informed consent, safety monitoring, and supervision of staff administering the chemotherapy.This requires expertise in chemotherapy administration, and potentially, interventional radiology techniques.

IMPORTANT 96423 (each additional hour of intra-arterial infusion),other CPT codes for related services such as catheter placement, and supportive medication administration codes (96360-96379).

In simple words: This code covers the doctor's work of giving chemotherapy directly into an artery using an infusion (a slow drip) for the first hour.A thin tube is placed into the artery leading to the tumor to deliver the medicine directly.

This CPT code reports the administration of chemotherapy drugs into an artery via an infusion technique for up to one hour.The procedure involves the placement of a catheter into the artery supplying the target area, followed by the slow delivery of the chemotherapeutic agent. This targeted approach ensures the drug reaches the tumor site directly. The code encompasses the time and effort involved in the procedure, including catheter placement and drug infusion for the initial hour.

Example 1: A patient with advanced liver cancer undergoes intra-arterial chemotherapy infusion for one hour targeting the hepatic artery. Code 96422 is used., A patient with inoperable colorectal cancer receives intra-arterial chemotherapy infusion via a catheter placed in the superior mesenteric artery.The infusion is performed for one hour using code 96422. The procedure requires specialized interventional radiology techniques., A patient with locally advanced pancreatic cancer is scheduled for intra-arterial chemotherapy. The procedure commences with catheter placement in the celiac artery, followed by a one-hour infusion of chemotherapy.This is coded as 96422.

Detailed documentation is required, including the indication for intra-arterial chemotherapy, the specific chemotherapeutic agent(s) administered, the location of catheter placement, the total infusion time, any complications, the patient's response to the treatment, and any subsequent management.

** The fluid used to administer the drug is considered incidental and not separately reportable.This code only covers the first hour of infusion; additional hours are reported using code 96423.

  • Revenue Code: P7B (ONCOLOGY - OTHER)
  • RVU: This information is not available in the provided sources and would require access to current RVU data. RVUs vary based on geographic location and other factors.
  • Global Days : The global period for this procedure is not specified in the provided sources.Refer to payer-specific guidelines for details.
  • Payment Status: Active
  • Modifier TC rule: A Technical Component (TC) modifier is not typically applicable to this code as it directly reflects the physician's work.
  • Fee Schedule : Historical fee schedule data is not available in the provided sources. Access to this data requires commercial databases like those offered by Ingenix or other fee schedule providers.
  • Specialties:Oncology, Interventional Radiology
  • Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgical Center
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