SuperCoder Posted Tue 27th of August, 2013 16:01:15 PM
please help with coding and billing of administration of 500cc n/s IV in office setting.
SuperCoder Answered Wed 28th of August, 2013 17:09:34 PM
Look at 96360-96361 and J7030-J7050.
For proper coding, you need to have precise start and stop times for the infusion. You also need a diagnosis that shows medical necessity, such as dehydration (as opposed to keeping a line open in between other infusions).
Assuming this is a medically necessary infusion, if it’s 30 min or less, CPT guidelines state not to report IV infusion of hydration separately.
If it’s 31 minutes to an hour (really 90 minutes as explained later), and the n/s is the only infusion performed (e.g., there wasn’t another therapeutic drug infusion administered as the primary reason for the visit that will be coded as the initial infusion), then use 96360.
Then look at +96361 for each additional hour (minimum 31 minutes) past the initial infusion. So once you hit 91 minutes total, you can report 96360 for the first hour and +96361 for the additional 31 minutes past the initial hour. Once you hit 151 minutes (2 hours + 31 minutes), you can report another +96361.
For the n/s, 2 units of J7050 is likely, but check your documentation against J7030-J7050 to be sure you have the proper match for what was administered.