Maiu Posted Thu 08th of December, 2011 11:17:13 AM
Can 96365 Intravenous infusion be billed if it lasts for 15 min?
SuperCoder Answered Thu 08th of December, 2011 11:33:47 AM
No. If it would have more than 30 mins, you could have been billed it. Descriptor says up to 1 hour, still it need at least more than 50% time.
Maiu Posted Thu 08th of December, 2011 11:36:45 AM
Maiu Posted Thu 08th of December, 2011 11:53:12 AM
I thought it has to run at least 16 min to be able to bill 96365, not 30 min.
SuperCoder Answered Thu 08th of December, 2011 11:55:47 AM
Firstly, most of the cases, it can be used after 50% time of one hour.
Secondaly for code 96374, it depends upon specific situation. 96374 is for IV push within the infusion time if it is given and should be billed both as per time frame . Please refer CPT Asst. 2009 to get valuable information.
Maiu Posted Thu 08th of December, 2011 12:18:02 PM
If a doctor reports 96365 for administrating 40 Toradol for 5 min, then how should this be billed correctly? Am I asking these questions in a wrong place?
SuperCoder Answered Thu 08th of December, 2011 12:32:37 PM
Yes, you could bill 96374. You are correct in this case. If infusion is less than 15 minutes, you can't code IV infusion code rather you could code IV push.
Recent guidelines: CPT defines an IV or intra-arterial push as “an injection in which the healthcare professional who administers the substance/drug is continuously present to administer the injection and observe the patient, or (b) an infusion of 15 minutes or less.”
Multiple codes exist for IV pushes. Base code selection on whether the push is initial or subsequent, and how much time elapses between multiple pushes of the same substance or drug. For multiple IV pushes of the same substance or drug, use code 96376, but only if 30 minutes elapse between the reported pushes. Note that this code is only for facility reporting of each additional sequential push of the same substance or drug. Again, coders cannot assign this code unless 30 minutes have passed since the prior injection of the same substance or drug.
For multiple intramuscular (IM) or subcutaneous injections, assign code 93672. This is the only code for these injections. When multiple IM or subcutaneous injections are administered, coders can report each of them.
Maiu Posted Thu 08th of December, 2011 13:16:55 PM
Ok, thank you. If infusion runs for 20 mins, is it appropriate to bill 96365 or is 96374 correct?
SuperCoder Answered Thu 08th of December, 2011 14:00:48 PM
If it runs for 20 mins, you could report 96365.