2025 HCPCS code Q0081

Infusion therapy, excluding chemotherapy administration.

This code should be reported once per visit, regardless of the number of medications infused.Refer to HCPCS S codes for home infusion therapies and check payer policy on their usage.

Medical necessity is established when the patient's condition requires intravenous administration of medication for effective treatment and oral medication is not a viable option. The documentation should support the clinical rationale for choosing infusion therapy.

The provider sterilizes the insertion area, inserts the needle/catheter into the appropriate access point, sets up the infusion device (cannula, drip, central line, PICC line, or port), administers the medication intravenously, and removes the needle/catheter at the end of the session.

In simple words: This code covers giving medicine through a needle or tube into a vein, not for chemotherapy, but for other treatments like infections, dehydration, or special nutrients.

Infusion therapy for conditions not treated by chemotherapy, including antibiotic/antiviral treatment, hydration, parenteral nutrition, blood factors, corticosteroids, and growth hormones. Administration of medication through a needle or catheter into a blood vessel, indwelling intravenous line, subcutaneous catheter, or port using devices like cannulas, drips, central lines, PICC lines, or implantable ports.

Example 1: A patient with a severe infection requiring intravenous antibiotics receives infusion therapy using a PICC line., A patient with dehydration receives intravenous fluids for rehydration using a peripheral IV cannula., A patient with a gastrointestinal disorder receives parenteral nutrition via a central venous catheter.

Documentation should include the type of infusion therapy, medication administered, dosage, route of administration, duration of infusion, and the patient's response to the therapy.The medical necessity for the infusion therapy should also be clearly documented.

** Q codes are used for drugs, biologicals, and medical equipment/services not identified by national Level II codes when needed for Medicare claims. Prior authorization might be required by the payer for services represented by Q codes.

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