HCPCS code S9379: Home infusion therapy, infusion therapy, not otherwise classified, per diem

Understand how to properly use and bill code S9379, the HCPCS code for home infusion, with our short guide.

## **What is HCPCS code S9379?** HCPCS code S9379 has a code description of "Home infusion therapy, infusion therapy, not otherwise classified; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem." It describes ongoing, continuous infusion therapy administered at home, billed weekly, and is used for patients on long-term infusion regimens, such as antibiotics, chemotherapy, hydration, or pain control. The code covers the professional services, equipment, and supplies required to maintain therapy, but excludes the drug cost. Maintenance therapy implies the patient has already been stabilized on the regimen and is continuing treatment for an extended period.

## **HCPCS code S9379 documentation requirements** Proper documentation is crucial for the successful billing of S9379. Here are the key requirements: - **Clinical information**: The patient's case file must contain clinical information about the diagnosis, a detailed plan of care, and documentation of the patient's progress and response to the therapy. - **Informed consent**: Documentation of the patient or caregiver's informed consent for home intravenous (IV) therapy is required. - **Medical necessity**: The documentation should clearly support the medical necessity for the home infusion therapy. - **Medication details**: Include the original medication order, pharmacy notes on preparation, and a record of medication administration. - **Delivery and shipment**: If applicable, records of the delivery or shipment of medications and supplies should be maintained.

## **S9379 billing requirements** Billing for S9379 must adhere to specific guidelines to ensure proper reimbursement: - **Per diem**: S9379 is a per diem code, meaning it is billed once per calendar day that a drug infusion is administered. - **Place of Service (POS)**: The claim must be billed with the "Home" place of service code (POS 12). - **Separate billing**: Remember that the per diem charge for S9379 does not cover the drug or nursing services. Do note that drugs and nursing services are billed separately. - **Modifiers**: Specific modifiers like SH (second concurrently administered infusion therapy) or SJ (third or more concurrently administered infusion therapy) may be necessary if multiple infusions are administered on the same day. - **Payer review**: The use of a "not otherwise classified" code like S9379 often requires a manual review by the payer's claims processors, which may necessitate the submission of additional documentation.

## **Other related codes** - **S9542**: Home injectable therapy, not otherwise classified, including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem - **S9325**: Home infusion therapy, pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem

Frequently asked questions

S9379 should only be used when a therapy is not specifically described by a more specific per diem "S" code. This is common for emerging or less common therapies.

Yes, the per diem payment for S9379 includes all necessary supplies and equipment, such as infusion pumps, tubing, catheters, and dressing kits.

S-codes like S9379 are temporary national codes and are generally not used for Medicare billing.