Q&A IV Push/Hydration

[Kathy O'Neal]

If a patient's cc is throwing up/diarrhea, and the patient received an IV Push of Zofran & hydration for 2 hours, would it be coded as 96374, 96361 (2)? Also, are there any cheat sheets or flow charts that explain how to code infusions, pushes & hydration's?

Thanks for your help,
Kathy O'Neal, CPC

 

[Amy Jeter CPC]

yes you would code 96374, 96361x2. only thing really to know on coding infusions/pushes/hydrations is Infusions are always have the hierchy then iv pushes and/or hydration would be secondaries. If patient is receiving Chemotheraphy infusions/IV push the chemo icpts will be the initials and all others will fall secondary.

 

[Alicia Scott]

This is good information Amy. Let me clarify to make sure I am repeating this correctly...
The hierchy is:
Infusions
IV Push and/or Hydration

In the case of a chemo treatment that trumps everything else. (I think it is always given in an IV but not sure)

I am getting ready to do a webex interview with a Ca coder/auditor and this will give me some more information to ask about.
Good stuff!!!!!

 

[Amy Jeter CPC]

There are some Chemo drugs that are given as SQ/Im in that case you will bill the Chemo sq/IM cpt code and any infusions suppliment meds you would bill as the "initial" IVP if < 16 minutes or infusion if > 16 minutes then any additonal drugs as additional push if 16< or additional sequential if >16. Hydration can ONLY be billed if > 30 minutes and it truly is hydration (with some of our drugs we have to flush between infusions those don't count as hydration time). If you have any more questions or would like some examples I would be glad to help.

 

[Alicia Scott]

I would love as many examples as you can give me. Can you email them to me: Alicia@CodingCertification.org

 

[Kathy O'Neal]

Thanks Amy for the confirmation! I've had a great mentor in explaining infusions, ivp's & hydration & have come up w/ a cheat sheet for this. I also listed a reminder to charge for the supplies (drugs & saline.) This works well in education nurses & front desk who need to make sure all the charges are capture on an encounter form.

 

[Amy Jeter CPC]

Alicia I emailed you let me know if you haven't received. Thanks

 

[Alicia Scott]

I got them and they are awesome. Do I have permission to use them any way I want? You know I am crazy about education.

 

[Kathy O'Neal]

Amy,
Are you saying the therapeutic injection 96372 doesn't play a role in the hierarchy & it's chemo 1st, infusion 2nd, ivp 3rd, then hydration. Correct? Also, can you clarify what it means for physician reporting, based on the clinical condition as stated in the guidelines? I work in an urgent care, so I follow the hierarchy. Is there something else I should be taking into consideration?

Thanks!

 

[Amy Jeter CPC]

Kathy 96372 has no Heirarchy its an Im/SQ injection. Heirarchy only involves anything that is Time based and infused via IV or port. Urgent care would not be administering chemo so if you are treating a pt for dehydration due to nausea/vomiting/diarrhea and the physician orders Zofran and fluids, the Zofran if IV infused runs for 20 minutes and the Saline 500 runs for 30, the Zofran would be the primary with CPT 96365 and you can not bill for the fluid hydration as it has to run over 30 minutes to be billed. After these run and the DR decides to add an addtl bag of saline 500 for addtl 30 minutes you can then bill for hydration because the accumilative time is over 30 minutes. You would then bill 96365 (1) for Zofran and 96361 (1) for the hydration. I hope that makes sense.

Alicia yes you can use the scenarios I gave you.

 

[Kathy O'Neal]

Amy,
Thanks for clarifying!

 

[Ruth Sheets]

This was covered in the May 2013 Q&A Webinar. CCO Club members get the transcript, video clips, and answer sheets to all the previous webinars... awesome deal!
Here is a blog post that discusses this topic:
https://www.cco.us/forum/threads/coding-iv-push-and-hydration-–-video.1130/

 

[Kathy O'Neal]

I have 2 flowsheets (cheatsheets) that we use if you'd like to see them. They've been very helpful!

 

[Linda]

Hi all
In the case of hydration before chemo infusion if it is over 31 mins can it be charged separately?

 

[Amy Jeter CPC]

Linda to clarify your question. If it is "hydration" and >31 minutes then yes you can charge for hydration add on 96361. If this is just for premed iv infusion then no you can not bill.

 

[Linda]

Ty Amy ))))