Charge Infusion

How medaptus Codes Your Infusion Charges — Automatically

An automated rules engine that reads directly from your EHR and applies the full chemo, therapeutic, and hydration hierarchy — no manual entry, no double documentation.

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Charge Infusion — Autonomous Coding
ENC-88291 · Oncology · Outpatient Infusion
Billable Codes
Hierarchy
Duration
Modifiers
Billing Summary
Order: FOLFOX regimen — Leucovorin, Fluorouracil, Oxaliplatin. Cyclophosphamide 600mg/m², administer over 1.5 hrs, starting 60 min after treatment start.

Billable Codes

4 CODES
1
96413 — Chemo, IV infusion, initial up to 1 hr
Oxaliplatin
Evidence
✓ Pump record: "Oxaliplatin infused 08:14–09:46, continuous rate."
2
96417 — Chemo, IV infusion, each additional sequential hour
Oxaliplatin — duration exceeded 1 hr threshold
Evidence
✓ Duration calculated at 92 minutes from pump start/stop — 1 additional unit beyond the ordered 90.
3
96365 — Therapeutic, IV infusion, initial up to 1 hr
Leucovorin — reclassified from chemo
Evidence
✓ CMS drug list: Leucovorin given with chemo, but classified as therapeutic, not chemo.
4
Not billable — Hydration
Normal saline — keep-vein-open rate
Evidence
✓ Nursing note: "NS at KVO rate, not a separately billable hydration."
Billable Units
3
Encounter Duration
92 min
Caught by Automation
+1 unit, 1 reclass
Handoff
Ready to Bill
How It Works

Infusion Coding Is Complex — But It's Logical & Automatable

Charge Infusion reads what's already documented in the EHR and runs it through the same duration-based hierarchy your coders apply manually today — just without the re-entry, the rounding, or the missed minute.

⚙ Fully automated — steps 1–3 run with no manual entry, no coder review, no double documentation.
Step 01

Capture from the EHR

Pulls drug, route, site, and start/stop times directly from documentation already recorded — nothing re-entered.

Step 02

Apply the hierarchy

Classifies each drug — chemo before therapeutic before hydration — against the full CMS drug list, catching misclassifications like Leucovorin.

Step 03

Calculate duration & units

Applies short vs. prolonged infusion logic, rate changes, and pause/restart events down to the minute.

Step 04 · Human touchpoint only if needed

Bill or hold for review

Clean encounters go straight to billing automatically. Anything with a real gap — like a missing stop time — is held for your coders to resolve.

What's At Stake

A One-Minute Rounding Error Is a Real Dollar Amount

Outpatient infusion reimbursement is based on many specific factors, such as duration — and the difference between "about 15 minutes" and 16 minutes changes what you're paid.

$28–$32
Lost per infusion when a missing stop time forces a downcode to a "push" charge
$32–$34
Lost per infusion on a single-minute rounding error (15→16 min, 90→91 min)
60 mins
It can take coders up to one hour to code an infusion encounter – that’s a maximum of 8 encounters/day/coder
At just 1 error in every 10 infusions, that adds up to more than $300K in lost revenue per 100,000 infusions — before accounting for coder time.
The Impact

What Automation Changes

80–90%

Productivity increase across billing, coding, and revenue cycle workflows

10%+

Average annual revenue improvement from previously missed or downcoded charges

100%

Of charges compliant, backed directly by what's documented in the EHR

Based on medaptus analysis of anonymized outpatient infusion data across multiple infusion centers, volume of 100,000+ infusions.

Two Ways to Get Started

Not Ready to Trial on Your Own Data Yet? Start with Proof.

See what an automated infusion audit finds on data like yours — or code your own charts free.

No Data Required

See an Example Audit

We'll send you an anonymized infusion audit report — the same findings our team surfaces in real infusion center audits — so you can see what typically gets caught before sharing anything of your own.

No data shared. No BAA required.

100 Infusions, Free

Code My Own Data

Ready to see it on your own encounters? We'll code 100 infusions at no cost — codes, hierarchy logic, and accuracy on your own data.

  1. 1
    Send 100 infusions
    Your real production encounters
  2. 2
    See the results
    Codes, hierarchy logic, and revenue impact on your own data

No cost. No commitment. BAA signed before any data is shared.

See Automated Infusion Coding in Action

Start with an example audit, or code 100 of your own infusions free.

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