# Can you charge 2 pushes at same time?



## GAcoder (May 6, 2014)

Can you charge 2 or more pushes that run at same time different meds?  Thanks for info.


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## atheri992 (May 6, 2014)

Yes, but one would be charged as an initial IV push (96374), and the second med as an injection new drug add on (96375).  If it were the same drug push, then it can only be charged 30 minutes after the first one was given.

This is of course if there were no infusions given (not hydration).  If there was an infusion at any point whether before or after those pushes came in the ED, then you would charge 2 IV injection new drug add on codes (96375 X2).


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## GAcoder (May 6, 2014)

I'm in urgent care so can't code addl same drug push. Not facility 
Thank you for your help


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## ramirez505 (May 31, 2014)

*can u charge 2 Ivp the's given at same time*

IVP's and infusions are based on start and stop time.  If you have 1, 2 or 3 IVP's given at same time than they = 1.  Same thing with IM's, if same time = 1.


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## pammalou (Jun 9, 2014)

I would agree, if they are pushed at same exact time, they would be counted as one push.


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## kwatterson (Oct 13, 2017)

*3 ivp*

Can three different pushes of three different meds be coded? 96374 and 96375x2. thanks!


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## OncologyOKC (Oct 26, 2017)

kwatterson said:


> Can three different pushes of three different meds be coded? 96374 and 96375x2. thanks!



Yes, 3 can be billed but only if they are documented at different times.  If only 3 IVP's were done that encounter then yes it would be 96374, 96375X2


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## jzaato2010 (Oct 28, 2017)

What if there are two separate IV sites.... ?
I am struggling with if a patient has an initial drug infusion in one arm and say.... 2 pushes in that same site but also has an initial push in the other arm... So we are looking at, for example:

Right arm IV site
96365
96375x2 

and 
Left arm IV site
96374

Does that 96374 need a modifier of any kind since I have an initial on the right arm and an initial although a different type of initial on the left?

Thank You


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## OncologyOKC (Feb 2, 2018)

I have never personally had this happen.  All pushes given are all given via original access site.  I would however, think you would not be able to get an additional Initial infusion paid. 



jzaato2010 said:


> What if there are two separate IV sites.... ?
> I am struggling with if a patient has an initial drug infusion in one arm and say.... 2 pushes in that same site but also has an initial push in the other arm... So we are looking at, for example:
> 
> Right arm IV site
> ...


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## KimReid (Feb 19, 2018)

jzaato2010 said:


> What if there are two separate IV sites.... ?
> I am struggling with if a patient has an initial drug infusion in one arm and say.... 2 pushes in that same site but also has an initial push in the other arm... So we are looking at, for example:
> 
> Right arm IV site
> ...



Yes, if another infusion or IVP is started at another site (i.e. infusion at left ac and then infusion at right hand) you can charge a second initial infusion or IVP. For the second initial service you'd have to add modifier -XS to show that it was a separate site. 

Kim R, CPC
ED Coder and Medical Records


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## ens555 (Jan 6, 2019)

*Coding IVPs administered at the same time*

Where I work we do not code 2 IVP administrations for Dilaudid & Zofran as well as for morphine & Zofran when given at the same time.  This is because the RNs combine these particular drugs into 1 administration.  I don't know how universal the practice of combining these IVP meds is. 

ens555


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## ens555 (Feb 3, 2019)

*charging IVPs given at the same time*

Here are some other thoughts:  reach out to your ED nurses via the appropriate person to find out what's really happening.  I've been told that the RNs combine certain drugs into one push; commonly IVP Zofran with IVP Dilaudid or IVP morphine.  Many drugs are NEVER combined.    Let's say that   96374 has already been given.  Then if I see subsequent meds IVP morphine & IVP Zofran are both given at 10:00 I code 1 push, 96375. Or if I see IVP diphenhydramine & IVP Toradol are both given  at 10:00 I code 2 pushes or 96375 x 2.

Other thoughts:  Patients with multiple IV access sites are often the very sick/critical patients.  I would check for medical necessity before coding for 2 initial IV injection codes.

I welcome all feedback on these thoughts.

Thank you,

ens555


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