# Hospital Charging for IV Infusion/Injection Start and Stop Times



## MRKOCUREK (Nov 11, 2009)

Medicare's guidelines state that hospitals must record start and stop times for all IV infusion/injection in order to bill the time charge appropriately. We have a big challenge with this hospital wide, as our equipment is an automatic procedure in which we document the start time and it runs continuously until it shuts off. Most times, the nurse is not in the room to document the stop time. How are we supposed to document the stop time in this situation. Does Medicare want everyone to sit in the chair and look at every drop until it finishes. I cannot be the only one with this issue. 



Everyone's thoughts????


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## clmoreland (Nov 11, 2009)

*Infusion start stop time*

What you can look at is the nurses documentation if they hang a medication and it is to run for say over one hour; they should document in their notes that they started it at Time A and stopped at time B, noting if there were any problems with infusion or if it infused without problems.  From my background of nursing, when we go back to a patients room and their IV medications have ended, I document the time I take down the medication bag; now the machines they use for their infusions, does it have a read out of the times started and stopped?  Something within the device they can go in and look at the infusion time etc, rate etc.

Not sure if this will help but this is what I encountered when I worked in nursing.


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## jtuominen (Nov 11, 2009)

This has been one of my facility's biggest improvement goals this year. I do Interventional Radiology and Cardiology coding and we were able to use our hemodynamic measurement system to chart the start and stop times of our infusions. This has been a huge lifesaver. For other procedures that don't utilize this system I do a 100% audit of all of our operative pathways to see if infusion start and stop times are documented. If they aren't there I bring them back up for late entries. It has been laborious, but after a year we are finally seeing significant documentation improvements in my service and in others. Good luck!


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