Mario Posted Wed 08th of December, 2010 17:38:33 PM
Can both Codes be billed on the same patient 96360 and 96365 or should just one or the other?
Patients comes in and need to be on IV Fluids for 12 to 24 hrs to hydrate, Pain medication, Antibiotics are ordered every 8 hrs.
should I code 96360 first and then 96361 for every for each aditional hour and everytime the nurse goes and does a push bill also 96374
Is this right or how should this be codes
or can you please give me an example of how to use the codes 96360,96361, 96365, 96366 96369 and 96374
Elissa Answered Wed 08th of December, 2010 18:31:39 PM
You would code the 96365 first and the then 96361 for the hydration and any injection would be 96375. This is the hierarchy of drugs
■Non-chemo, therapeutic infusions
■Non-chemo, therapeutic injections
SuperCoder Answered Wed 08th of December, 2010 19:33:05 PM
For first 1 hour of IV hydration: 96360
For subsequent hours of hydration: 96361 for each additional hour, i.e, here if there is say 24 hours of hydration, then it would be : 96360 and 96361 x 23
For Prophylactic IV infusion: 96365 for first hour of infusion.
From 2nd hour onwards, for each additional hour: 96366 x no. of each additional hour.
For Prophylactic Subctaneous Infusion for first hour: 96369
For Single or Initial substance (therapeutic,prophylactic,diagnostic): 96374
For additional IV push of new substance (therapeutic,prophylactic,diagnostic: 96375
Is this what you wanted to know ?
SuperCoder Answered Thu 09th of December, 2010 03:22:46 AM
According to CPT for facility coding chemotherapy services are primary to theraputic, prophylactic and diagnostic services which are primary to hydration services. Infusions are primary to pushes, which are primary to injections. Hydration codes are facility reporting only.
For physician reporting initial code that best describes the primary reason for the encounter should be reported irrespective of the order in which the infusions or injections occur.
According to CPT we can report 96374 and 96361, but we cannot report 96360 and 96375 as 96374 is primary to 96360.
Coding for Hydration:-
Hydration may be billed separately only if it is given prior to or subsequent to drug infusion. If it is given concurrently to facilitate drug delivery, it is considered included in the drug infusion. If hydration is less than 30 minutes then it is not billable and the reson is that if it is less than that then it is not therapeutic and cannot be dehydration. Also look at the rate the fluids are running at, that will tell you if it is for hydration and not just for convenience. Therapeutic rate is 125cc/hr. Heplock and KVO(keep vein open) are not coded.
Intravenous Push (IVP) [is an infusion which runs up to 15 minutes] :- [96374 & 96375]
96374 code should not be used if 96365 or 96360 are in use instead use 96375 with appropriate units for number of drugs.
Therapeutic Hydration:- [96360 & 96361]
[Saline infusion that run for more than 30 minutes are considered as therapeutic hydration. Saline infusion for less than 30 minute is not coded.]
96360 should not be used if 96365 is in use instead use 96361 with appropriate units for number of hours of hydration.
Intramuscular Injection :-
96372 (Need to use 59 modifier in if used conjunction with above codes)