# IV Questions



## michaelrcpc (Aug 5, 2011)

When used for hydration prior to chemotherapy:
 
IV bag contains medications (non chemo) added by pharmacy (potassium, magnesium, vitamin Ketc) - is it considered IV therapy or IV infusion hydration 


IV bag premixed by manufacturer containing medication what is one coding for this


----------



## jackson7591 (Aug 8, 2011)

*Reference*

If you look under the pediatric section, Thread is. "dextrose in an IV"

There are specific links that address your question.  According to these documents, addition of substances, regardless of who does it, renders it a drug infusion.  I'd double check the codes for drug infusion and hydration as i think they may have been updated.


----------



## Mojo (Aug 8, 2011)

Jackson is correct, the injection and infusion codes changed in 2009.

Michael, I would consider both of your examples as therapeutic infusions if given over a period of greater than 15 minutes; if the second example is a premixed bag of a liter of IVF with 20 mEq, it is used for hydration.


----------



## michaelrcpc (Aug 9, 2011)

Thanks


----------



## michaelrcpc (Aug 11, 2011)

So in summary, anytimne a drug is mixed it is considerfd an Infusion.  Gottcha'

No, would the coding of the IV premixed bag containing medication be coding dependant upon what med. is mixed correct????

Thanks for your assistance.


----------



## Mojo (Aug 11, 2011)

Well, let me add to the infusion confusion. CPT describes hydration to consist of a pre-packaged fluid and electrolytes (eg, normal saline, D5 1/2 NS with 30 mEq KCL/liter) but are not used to report infusion of drugs or other substances. Because it is not cost-effecient to stock IVFs with varying amounts of KCL (manufacturers only make a few solutions, anyway) and some docs will order 15 mEq, 40 mEq KCL for their hydration orders, pharmacy will mix these bags. I still consider them hydration. It is when the potassium is being replaced with KCL in a smaller volume of solution, it is considered therapeutic because it is given to replace electrolytes, not to hydrate the patient. Some other therapeutic replacement infusions of electrolytes contain calcium, phosphorus or magnesium sulfate.

Banana bags, usually a liter of fluids with thiamine, folic acid, magnesium sulfate and MVI (turns the IVF yellow) is a therapeutic infusion. These are mixed by pharmacy. There are many premixed infusions: antibiotics, Dopamine, Heparin, Lidocaine, Zantac... They are therapeutic to treat a condition not to hydrate the patient. If you have any doubts just post and we can help you determine if the infusion is hydration or therapeutic.


----------



## kemptar (Aug 28, 2013)

Sorry I'm still confused on hydration vs infusion. A banana bag is considered therapeutic (infusion) but dextrose 5 % and 0.9% NaCl 1,000 mL with potassium chloride 20 mEq is considered hydration? At what point are the additives considered therapeutic? I was thinking that any additives were considered infusions but I found that lacted ringers solution is also just considered hydration. Does anyone have any experience with making these determinations from a non-clinical coding viewpoint? Thanks!


----------

