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hydration, infusion , and intial codes

Tonya Posted Thu 15th of October, 2009 17:17:08 PM

CAN I CHARGE 96360 WITH 96365? I WAS TOLD I CAN NOT CHARGE 96360 WITH 96365 BECAUSE THEY BOTH WAS AN INTIAL CODE SO IF TH IV STARTS AS A HYDRATION AND A HOUR LATER A PUSH IS ORDERED I WAS TOLD TO NOT CHARGE 96360 TO CHARGE IT AS 96365 AND NOT TO CHARGE 96374 TO CHARGE THE PUSH AS 96375 BECAUSE THEY BOTH ARE INITIALS. AND I DON'T UNDERSTAND THE CONCURRENT 96368 WHAT IS THE DIFFERENCE WITH 96368 AND THE SEQUENTIAL 96367?? HELP PLEASE..

SuperCoder Answered Thu 22nd of October, 2009 14:06:07 PM

The Description of 96365 is 'Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour'

If you see the section notes above 96365 it says "A therapeutic, prophylactic, or diagnositic IV infusion or injection (other than hydration) is for the administration of substance/drugs.

It says 'other than hydration'. And sequential hydration (not concurrent to chemotherapy) can be billed separately.

Since 1 hour hydration has been given prior to IV push you should report 96360 and 96374

Ref: http://www.precysesolutions.com/featured_articles/Auditing%20IV%20Hydration%20Documentation%20and%20Coding.pdf

http://www.wpsic.com/medicare/part_b/policy/honc002.pdf

concurrent means given at the same time as any other IV and sequential means one administration follows the other as in your case.

I look forward to comments by others on this.

Thanks

Ash

SuperCoder Answered Fri 23rd of October, 2009 05:46:45 AM

you also need modifier 59 with 96374.

Thanks

Renee Answered Mon 02nd of August, 2010 13:43:58 PM

If posting for the hospital facility side you would post 96374 and 96361. 96360is an inital code and you can have only one initial code per encounter. According to the CPT guidelines IV push is primary to hydration. Drugs are always the initial code whether infusion or push. Under hydration +96361 states (Report 96361 to indentify if provided as a secondary or subsequent service after a different initial service [96360, 96365, 96374, 96409, 96413] is administered through the same IV access).

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