# IV drugs



## NJcoder (Oct 28, 2008)

Hi- if a patient receives 2 different drugs via IV infusion would i use 90765x2?  sometimes i see the drugs delivered the same time but often 2 or more different drugs are delivered different times?  thanks...


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## Kris Cuddy (Oct 28, 2008)

Corrected response:

Coding infusions will depend on what is being infused and how the drug(s) is infused.

Insurance carriers only allow one initial drug infusion administration, so 90765 cannot be coded twice on the same claim.

It appears you are asking about a few different possibilities in the question. Might you elaborate and I will try to help.

Kris


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## Lisa Bledsoe (Oct 28, 2008)

You can code separately for the drugs, but if they are administered via IV infusion simultaneously, there is not a separate infusion code.  Another scenario might be if one was given IV push, then you would use 90775 for the one going in by push while the other is infused.  Does that help?


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## NJcoder (Oct 28, 2008)

Both of you made it more clear for me. So, if one is IV infused (eg tordal) & the other IV push...i can use 90765 (initial) & 90775 (each addl)?  And if two different drugs are given via IV at different times but same DOS code only 90765 and HCPCS for all the drugs? 

Is IV infusion of fluids (90760) allowed to be coded with the above with modifier 59?


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## Lisa Bledsoe (Oct 28, 2008)

No -you can't code 90760 and 90765.  Hydration is inclusive to other infusions.  The best place to find an explanation of this is page 383-384 of the CPT Professional Edition.  (it's also in the standard edition, I just don't know the page numbers - under the heading of "Hydration, Therapeutic, Prophylactic, and Diagnostic (Excludes Chemotherapy)").


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## Kris Cuddy (Oct 30, 2008)

Laurie,

Whatever the reason is for the patient being given the IV drugs, is going to be what you use for the initial IV administration.

So, if the patient is coming for therapeutic infusion, along with an IV push, and it is not chemotherapy, the first code for administration would be 90765, if the IV lasts longer than 60 minutes, then also look at 90766 for each additional hour after the first hour. In order to use 90766, the infusion must go beyond 90 minutes total.

You are correct in going to 90775 for the IV push as the second administration, as long as the medication being pushed is given after the infusion (sequential) and not along with (concurrent) the infusion.

As you may see, documentation of start and stop times of infusions and pushes will be vital to being able to code drug administration correctly.

Lisa is correct that hydration administration cannot be billed if other drug administration codes are being billed for the encounter. As well as her recommendation to read the CPT preambles and instructions for better understanding.

After reading that information, perhaps post an actual scenario and we can help you determine the appropriate codes. We can discuss and discuss drug administration, usually though, I've found that it becomes much clearer when coding actual cases.

Kris


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## ctodicheeney (Apr 21, 2009)

*Banana Bag Scenario....*

Please help me with this scenario:  Pt is infused with Saline, Multivitamin, Magnesium, and Ativan (Injected), would I use the following codes:
J3475, J7030x3, J2060 and J3490 (for MV)? or should I use another code for the Multivitamin??  Please send response to ctodicheeney@yahoo.com thx ct


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## ramirez505 (Apr 23, 2009)

*infusions/ivp/hydration*

you have to consider that there is a hierachy to follow, when trying to figure out your meds.  Inusions first (ivpb that last >15 mins.  ivp's are second and hydration is third.  So you look at your med documentation - is there an infusion? no? ivp? yes? then your ivp becomes your primary and hydration is secondary (additional).  if infusion - infusion is primary and everything else becomes additional.


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