Brenda Posted Wed 01st of February, 2017 15:27:03 PM
WE HAD A PATIENT IN OUR OFFICE WHOM WE PROVIDED CRITICAL CARE FOR FOR 6 HOURS AS PT REFUSED TO BE TRANSPORTED TO THE HOSPITAL. DURING THIS TIME PT RECEIVED IV THERAPY 96365, 96366. MY QUESTION IS CAN I BILL THE IV THERAPY IF I AM BILLING FOR CRITICAL CARE. BOTH SETS OF CODES RELY ON SIGNIFICANTLY ON TIME THEREFORE I AM NOT SURE IF THAT IS APPROPRIATE BECAUSE I WOULD BE BILLING FOR TWO DIFFERENT SETS OF CODES THAT OCCURRED IN THE SAME TIME FRAME? ANY HELP WOULD BE GREATLY APPRECIATED.
SuperCoder Answered Thu 02nd of February, 2017 02:14:55 AM
CPT 96365, 96366 will be paid seperately with modifier 59 along with critical care. However, infusion time should not be less than 50% time of 1 hour. Hope it helps.