2025 CPT code 96521
(Active) Effective Date: N/A Medicine - Chemotherapy Administration and Other Highly Complex Drug or Highly Complex Biologic Agent Administration Feed
Refilling and maintenance of portable pump.
Modifiers may be applicable to this code in certain circumstances (e.g., reduced services, discontinued procedure). Refer to current CPT guidelines for proper modifier usage.
In simple words: The doctor refills a portable pump that delivers chemotherapy medicine.
The provider refills a portable pump with a chemotherapy drug.Patients receiving chemotherapy drugs to treat diseases such as chronic pain or cancer may need an infusion of chemotherapy for eight hours or more. The provider administers the drug to the patient through a portable pump in the office, and the patient leaves the office afterward. The patient may need to return to the office the next day for a pump refill to continue infusion, which this code represents.
Example 1: A patient receiving chemotherapy for breast cancer comes to the office to have her portable chemotherapy pump refilled so she can continue treatment at home., A patient with chronic pain is receiving prolonged opioid infusion therapy via a portable pump. He returns to the office for a refill of the pump and to have the dosage adjusted., A patient undergoing chemotherapy for lymphoma has a portable pump that was disconnected after completing a cycle of intermittent infusions. She returns to the clinic to restart infusions, requiring the pump to be refilled and reconnected, thus code 96416 is used in this scenario, not 96521.
Documentation should include details of the pump refill (drug, dosage, date, and time), maintenance performed (if any), and the patient's response to therapy.
- Specialties:Medical Oncology, Hematology, Pain Management
- Place of Service:Office, Outpatient Hospital