Coding Corner Question

A 58-year-old man with RA returns for his scheduled infliximab infusion. Thirty-five minutes into the infusion, after receiving only 200 mg of infliximab, the patient develops a severe reaction. The physician discontinues the infusion and flushes the line with normal saline. The patient is given an intravenous injection of 40 mg of methylprednisolone sodium succiante. The patient also receives oxygen by nasal cannula at two liters per minute. The physician continues the intravenous hydration of saline for 40 minutes. Because the patient had such a severe reaction to the infusion, the physician performed a full medical examination on the patient. The visit comprises a detailed history and detailed examination, and the medical decision-making was of high complexity.