# J1642 and Normal Saline



## jjstauffer62 (Jul 8, 2013)

I would love some help on this issue.  I work in an Infusion center.  
First issue is the billing of heparin J1642-that is placed in port at the end of their infusion to keep line ready for next time.  Billable or Non billable
Second issue is billing of the Normal saline flush bags-used for different reasons than hydration, flushing the lines between chemo, able to flush if the patient has a reaction, etc.
Billable or non-billable.  Some of the rules are a little confusing.  
Any help appreciated,
Jennifer Stauffer, CPC


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## dtricia (Jul 9, 2013)

*J1642 and saline*

I have a Noridan article that states " Also note that Medicare will not provide payment for the HCPCS code J1642 "Injection, heparin sodium, (heparin lock flush), per 10 uites' whaen used for the purpose of flushing/irringating a vascular access device. When heparinis used only for port irrigation the heparin itself is not separately billable." 12/7/2010


2nd question To capture a port flush, use 96523 Irrigation of implanted venouse access device for drug delivery system. Can only be billed if no other service provided.

For all sites of service, flushing of a vascular access port prior to or after drug administration is considered to be part of the administration service and not separatley charged.


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## jjstauffer62 (Jul 9, 2013)

Thanks for your help!  I am not billing the 96523 at the end of chemo-just the J1642 heparin.  Do you know about the billing of the J7050 1 unit of flush bag that is placed to flush lines between chemos, in place for reaction-is that also inclusive.


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## dtricia (Jul 9, 2013)

*J1642 and Saline*

i  would bill that saline because, that hydration is medically necessary if done due to reaction. I would link it to the symptoms and E933.1
This would be billable as long as it is not concurrent to any drug infusion...must be only the saline running.

Tricia Didier, RHIT, CPC, CCS-P


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## jjstauffer62 (Jul 9, 2013)

Hi Tricia-
Yes, if they are reacting.  I do bill for the J7050... but, if the bag is just connected to the patient to flush in between drugs, or there just in case the patient would react-makes it faster to flush the line...would you bill that 1 unit of flush bag. I appreciate all of your clarification on this matter.
Jennifer Stauffer, CPC


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## dtricia (Jul 10, 2013)

*J1642 and Saline*

No, I would not consider that billable.
Tricia


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## jjstauffer62 (Jul 10, 2013)

Tricia-
Thank you so much for all of your help!
Jennifer


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