A 65-year-old male diagnosed with chronic inflammatory demyelinating polyneuropathy is scheduled for a follow-up visit for an intravenous immune globulin (IVIg) infusion.
The patient advises the physician that he is also having minor joint pain in his left knee. The physician performs a detailed history and an expanded, problem-focused examination. The physician’s notes support medical decision-making of moderate complexity.
The IVIg infusion duration is three hours and 38 minutes. The patient is infused with 25 grams of Octagam, and one 250-cc bag of normal saline is used to establish venous access. How should this office visit be coded?