Hematology / Oncology, coding reference.

Select this level when at least two of the three MDM elements meet high complexity, or when qualifying total time reaches 60 minutes. A diagnosis, medication, or high-risk decision alone does not establish the overall level. For Medicare prolonged services with this time-selected base code, the first G2212 unit requires 89 minutes. Payers recognizing CPT 99417 use different thresholds.

Select this level when at least two of the three MDM elements meet high complexity, or when qualifying total time reaches 40 minutes. A diagnosis, medication, or high-risk decision alone does not establish the overall level. For Medicare prolonged services with this time-selected base code, the first G2212 unit requires 69 minutes. Payers recognizing CPT 99417 use different thresholds.

Consider the ongoing responsibility for the patient's care: either a continuing focal point for needed services or ongoing care of a serious or complex condition. It is not automatic for a diagnosis or specialty.

Initial IV chemo infusion of the encounter, up to 1 hour. Add 96415 for each additional hour, 96417 for additional drugs.

Each additional hour of the same chemo drug.

Sequential chemo infusion of a different drug after 96413.

IV push chemo. Use 96411 for each additional push of a different drug.

First therapeutic non-chemo IV infusion at the encounter.

Each additional hour of the same therapeutic infusion.