# Outpatient Intraosseous Infusion of Drug



## acw (Feb 22, 2013)

Do any of you know if the IV infusion codes are correct to code on an outpt coming in for drug infusion via intraosseous route? All info I have seen is no you cannot; however, all the information is for in emergency/code blue situations, and this situation is not an emergency.

Annette, CPC, CEMC


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## Pam Brooks (Feb 22, 2013)

Here's what I found:  

The AMA's CPT Knowledge Base states:
_Patients receiving intraosseous infusion are typically inpatients. Hence, the intraosseous infusion per se is performed by hospital nursing staff and not separately reported with any CPT code. The physician work of ordering of the infusion (rate/dose/duration) is already included in the appropriate level of the physician's inpatient hospital E/M service. Code 36680 (Placement of needle for intraosseous infusion) describes a procedure in which a hollow needle is inserted through the skin and through the muscle tissue to puncture the bone marrow cavity, usually in the tibia or femur of a patient, whose vessels are otherwise inaccessible. The needle is used as a method of infusing fluids into the blood vessels in the bone marrow. Therefore 36680 is the only code that can be used; do not use the 963XX codes for the infusion portion_


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## mitchellde (Feb 22, 2013)

Correct and you can bill the 36680 only if your physician performed that part of the procedure.  If not then you cannot bill that either.  
You need to check with the payer if your patient is not an inpatient for this procedure, as the payer pay not reimbusre for it in any other setting.


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## acw (Mar 1, 2013)

Thank you! 
Annette


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## pammalou (Feb 20, 2017)

But what if it is done in the ER?  That is where we seem to be having it completed.  If you are administering medications, it's not going into vein, so is that inclusive as well?


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## haskettdebbie@yahoo.com (Apr 15, 2022)

pammalou said:


> But what if it is done in the ER?  That is where we seem to be having it completed.  If you are administering medications, it's not going into vein, so is that inclusive as well?


I have been told , and have seen most patients are  critical , when coming to ER  , and was told to charge for the procedure of 36680 and the pharmacy charges for the medication being given thur the I/O line , all of the times I have seen it done have been done by the doctor himself , if a nurse were to do that , she would have to have an order from the physician
As far as I can tell , the guidelines have not changed since 2010 , so 36680 is the only code to be charged


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