billing the dmercs and others for infusion pumps - ION Solutions

COVERAGE CONDITIONS FOR EXTERNALPUMPS (E0779, E0780, E0781, AND E0791)v. Administration of other drugs if EITHER of the followingcriteria are met:1 Criteria:a) Parenteral admin of the drug at home is reasonable and necessary;b) An infusion pump is necessary to safely administer the drug;c) The drug is infused for at least 8 hours because of improved clinicalefficacy;d) The treatment regimen is proven or generally accepted to havesignificant advantages over intermittent bolus administrationregiments or infusions lasting less than 8 hours.2 Criteria 2:a) First 2 criteria in above ANDb) The drug is administered by intermittent infusion (each episode ofinfusion lasting less than 8 hours) which does not require the patientto return to the physician’s office prior to the beginning of eachinfusionc) Systemic toxicity or adverse events of the drug is unavoidablewithout infusing it at a strictly controlled rate as indicated in thePDR or U.S. P. D. I.