Gloria Posted Thu 01st of March, 2018 11:33:49 AM
Hello, Here is a scenario. If a patient came into the ER brought in by ambulance at 07:45 with altered mental status, triaged and assigned as a trauma patient in the ED. After labs & EKG were done and performed the physician wanted to intubate the patient at 08:19 and used Succinylcholine and Etomidate to sedate the patient for the procedure (given by IV push at 08:07). After intubation the patient was sent for imaging. Patient returns back to the ER trauma room and was given 3 infusions, Fentanyl at 08: 27 for 2 hours and 29 minutes, Versed at 08:30 for 2 hours and 26 minutes and Keppra at 09:03 for 1 hour and 53 minutes. They also gave a IV push of Ativan at 08:35. A Foley was inserted at 09:44. The decision was made to transfer the patient to an external facility and that was done at 10:56. Clinical impression was Acute Hypercapnic respiratory failure and seizure-like activity. My question is, can we charge for the IV Infusions of Fentanyl, Versed & Keppra along with the IV push of Ativan? I know that we cannot charge for the Succinylcholine and Etomidate because it was used for the intubation but does the same rule apply for any other drugs given to the patient while in the ER? Is the Foley chargeable? Lastly, if the IV infusions are chargeable and all given in the same site, would they be charged as 96365, 96367, 96368 & 96366 x 3 or 96365, 96367 x 2 & 96366 x 3? Thank you!
SuperCoder Answered Mon 05th of March, 2018 09:24:16 AM
Gloria Posted Tue 06th of March, 2018 12:20:29 PM
Thanks so much! Would the same rule apply if fentanyl was used for the intubation and given after as a infusion? Could we still charge for that drug? Is it only when used for CPR that we couldn't charge for the drugs?
SuperCoder Answered Wed 07th of March, 2018 22:57:29 PM