# IV Infusion



## kdw003 (Jul 3, 2008)

Can anyone help me figure this out. If patient presents for IV infusion for total of 3 hrs and also had one medication pushed in the IV, what is the correct sequence of codes to use? Thanks for any help


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## Lisa Bledsoe (Jul 3, 2008)

Taking a stab at this - assuming the infusion was for hydration:
90760, 90761 x2, 90775 (for the IV push).


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## kdw003 (Jul 3, 2008)

Thats what I thought but the 90775 denied because it was not a part of primary procedure.


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## STEVIERAY (Jul 3, 2008)

According to the CPT book "therapeutic, prophylactic, and diagnostic services are primary to hydration services". Therefore, your sequence would be 90774, 90761x3


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## Lisa Bledsoe (Jul 3, 2008)

CPT also states "when administering multiple infusions, injections or combinations, only one "initial" service code should be reporteds...The "initial" code that best describes the key or primary reason for the encounter should always be reported irrespective of the order in which the infusions or injections occur.  If an injection or infusion is of a subsequent or concurrent nature, even if it is the first such service within that group of services, then a subsequent or concurrent code from the appropriate section should be reported (eg the first IV push given subsequent to an initial one-hour infusion is reported using a susequent IV push code)."

I think you coded it right and need to appeal with CPT guidelines as above.

HAPPY 4TH!!


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## milant (Jul 21, 2008)

I have a ? my facility is having trouble finding info on adding hydration times. In our ER this happens alot. Here is an example:

1345-1710 HYdration
1349-1351 morphine
1352-1354 toradol
1355-1357 zofran
1630-1632 dilaudid

So between 1357 stop time of zofran and the 1630 start time of dilaudid is 2hr33min of just hydration. After the dilaudid is finished there is 38min of hydration. can these be added to gether to get 90761x3 or should it be 90761x2 not adding that last 38min of hydration?


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## racheleporterwilliams (Jul 21, 2008)

if any additive was given at the beginning hydration, the code range becomes 90765-90779...and saline is not reported

at least your facility uses start and stop times....wish my facility did this lol



milant said:


> I have a ? my facility is having trouble finding info on adding hydration times. In our ER this happens alot. Here is an example:
> 
> 1345-1710 HYdration
> 1349-1351 morphine
> ...


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## STEVIERAY (Jul 22, 2008)

The way we charge in our ER is 90774, 90775X3, 90761X3.


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## jccoder (Jul 26, 2008)

I agree with Stevieray.  I code for our hospital's ED and this is what I would have coded.


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## brina (Jul 26, 2008)

kdw003 said:


> Can anyone help me figure this out. If patient presents for IV infusion for total of 3 hrs and also had one medication pushed in the IV, what is the correct sequence of codes to use? Thanks for any help





Lisa Curtis said:


> Taking a stab at this - assuming the infusion was for hydration:
> 90760, 90761 x2, 90775 (for the IV push).





kdw003 said:


> Thats what I thought but the 90775 denied because it was not a part of primary procedure.



? Should you have used the 90774?
90760,90761x2, 90774, 90775
I'm still learning so forgive me if I'm reaching, but, the 90775 is an add-on. So it is to be used in conjunction with 90765,90774,96409,96413. If this is the case, then maybe you should have used the 90774 with the 90775. 
Again, still learning.


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## Lisa Bledsoe (Jul 28, 2008)

The 90774 is an initial code.  To get a push paid after an infusion has begun/is coded, you need to use subsequent.  "Report 90775 to identify intravenous push of a new substance/drug if provided as a secondary or subsequent service after a different initial service is administered through the same IV access."


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## brina (Jul 28, 2008)

Lisa Curtis said:


> The 90774 is an initial code.  To get a push paid after an infusion has begun/is coded, you need to use subsequent.  "Report 90775 to identify intravenous push of a new substance/drug if provided as a secondary or subsequent service after a different initial service is administered through the same IV access."



Lisa, what would be your complete code(s)?
Thanks.


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## Lisa Bledsoe (Jul 28, 2008)

brina said:


> Lisa, what would be your complete code(s)?
> Thanks.



Based on the original question or the follow up question?


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## tammyboyer (Aug 3, 2008)

*IV infusion*

i code these as:
90774 (this is considered the parent code---and the first push)
90761 x 3 

(i use 90761  because you cannot code two parents code together at the same time, 90760 with 90774-- both are Parents.  So i select 90774 for the first push, and per CPT guidelines in the book i then use the 90761 for the "time". .


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## arpdavis (Jan 8, 2009)

*Infusion and hydration*

What codes would you report???  A patient presents to the ED and receives IV hydration for 45 minutes.  Following the hydration, the patient also receives a drug infusion of 30 minutes.  In 2008, we would have coded 90765 (Drug Inf. Initial hour) and 90761 (each addit hr, hydration).  Our FI is saying 90761 would not be appropriate as there is not a total infusion time of greater than 90 minutes.  We think these are separate services and the time should not be combined.  Any thoughts, references???


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## arpdavis (Feb 12, 2009)

*Infusion and hydration*

Our FI has seen the light for the scenario below.  The proper coding is 90765 (for 30 minute drug infusion) and 90761 (for subsequent 45 minutes of hydration).  

What codes would you report??? A patient presents to the ED and receives IV hydration for 45 minutes. Following the hydration, the patient also receives a drug infusion of 30 minutes. In 2008, we would have coded 90765 (Drug Inf. Initial hour) and 90761 (each addit hr, hydration). Our FI is saying 90761 would not be appropriate as there is not a total infusion time of greater than 90 minutes. We think these are separate services and the time should not be combined. Any thoughts, references???


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## abc1099 (Feb 13, 2009)

kdw003 said:


> Can anyone help me figure this out. If patient presents for IV infusion for total of 3 hrs and also had one medication pushed in the IV, what is the correct sequence of codes to use? Thanks for any help


We administer chemo in an outpatient setting.  We would bill as follows:
Chemo as primary 96413 x 1 hr, 96415 x 2 hr additional, if the push was a chemo drug we would use 96411.  If the push is not a chemo drug then you use 96375.  Hydration can be given during chemo for dehyrdation 276.51 starting at 31 mins. to 60 mins. 96361 or if they only receive hydration that day, 96360 for 31-60 mins and 96361 for 91 mins or more.  Does this make sense?  Hope if helps.


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## cpccoder2008 (Aug 11, 2009)

abc1099 said:


> We administer chemo in an outpatient setting.  We would bill as follows:
> Chemo as primary 96413 x 1 hr, 96415 x 2 hr additional, if the push was a chemo drug we would use 96411.  If the push is not a chemo drug then you use 96375.  Hydration can be given during chemo for dehyrdation 276.51 starting at 31 mins. to 60 mins. 96361 or if they only receive hydration that day, 96360 for 31-60 mins and 96361 for 91 mins or more.  Does this make sense?  Hope if helps.



What is the IV infusions are two different drugs running concurrently for 2 hours and another chemo push ?
Would that be coded as 96413, 96417, 96411 ?? Also when coding for chemo do you need to add modifier's to these procedures ?


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