# IV coding has me  confused



## Deb Pugh (Dec 10, 2010)

When you start an IV and then inject Rocephin by IV do you bill 96360 AND 96374 or just the 96374?

Thanks in advance.
Debbie


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## medcoder9 (Dec 10, 2010)

I dont know the documentation but have you read the notes included in that 96360 code? 

It says to not report if performed as concurrent infusion service and it seems to me the scenario is a concurrent service.

So from reading the notes I think you just code  96374.


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## eadun2000 (Dec 10, 2010)

Debra Pugh said:


> When you start an IV and then inject Rocephin by IV do you bill 96360 AND 96374 or just the 96374?
> 
> Thanks in advance.
> Debbie



Is this for facility or physician coding?  If facility, it is 96374 and 96361 if the push was shorter than 15 minutes and the hydration was longer than 30 minutes.  However, all of that changes if it is physician.  I need to know what the patient came in for if physician so we know what order it is.


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## ramirez505 (Dec 10, 2010)

If you have a start and stop time for Rocephin and if the Rocephin runs over 15 mins = 96365
If you have a start and stop time, but Rocephin runs for less than 15 mins. = 96374
If you have a start time for Rocephin, but but no stop time = 96374
The IV hydration hrs = no information as to fluid running, the IV could have been capped or running TKO and since no information as to fluids running = no hydration hrs.  Hope this helps u.  : )


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## dk (Dec 13, 2010)

*keepcoding*

If the rocephin IVP is 12 minutes   96374
and the hydration is 35 minutes   
and the IVP is given as an overlapping service,  (IV started, then inject Rocephin)
Do you have to deduct the IVP time from the hydration services?
I am seeking formal examples... and references.. plz help

2010 May CPT asst clarification - the final sentences state:
... hydration may not be a concurrent and, therefore the duration of the pushes could affect the units reported for hydration.  Note that overlapping time may not be included...


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## pscott (Dec 13, 2010)

I think you cannot charge for the hydration at all, unless
the doctor gives a specific DX for it either.


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## ramirez505 (Dec 13, 2010)

Remember if you run Rocephine >15 mins, that will be your initial service and that will take 1 hr off your hydration hrs.  And then in order to to charge additional hydration hours, each additional hr requires a minimum of 30 mins, has to be given through same IV access and also, it does not matter if it ran before or after giving the Rocephin.

Concurrent = this applies only if 2 IV med infusions are running simultaneously ( same IV site at same time)
If you have a med infusion running and IV fluids running simultaneously (same IV site and  same time) you can only charge the med infusion.  You cannot charge IV fluid hrs as a concurrent charge.  Hope this helps  : )


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## cosita (Dec 14, 2010)

dk said:


> 2010 May CPT asst clarification - the final sentences state:
> ... hydration may not be a concurrent and, therefore the duration of the pushes could affect the units reported for hydration.  Note that overlapping time may not be included...



That CPT assist is just odd.  There is a lot of double talk in it imo.  

"The 2-hour duration of the intravenous "hydration" infusion from 1:00 pm to 3:00 pm is provided as a secondary service to a different initial service (code 96374). However, hydration may not be a concurrent service. In this instance, some portion less than 16 minutes of the 2 hours of "hydration" infusion, was concurrent. Therefore, the hydration is reported using code 96361 once"

Then in the last paragraph it says "Furthermore, the 2-hour duration of the intravenous hydration infusion from 1:00 pm to 3:00 pm is provided as a secondary service to a different initial service (96374)." In this instance, the 2 hours of hydration infusion is reported twice using code 96361 (2 units) as it is reported once for each hour of the 2-hour infusion."

In that example, if you do deduct 16 minutes for the 1:30 push that would take you to 104 minutes which would still be two hours of hydration so nothing is really clarified and it's just a bugger in my day trying to figure out how to do this. lol


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## 78079coder (Feb 11, 2011)

*re : IV coding has me confused*

I realize this is a bit after the fact, but I just came across this post. Not to intentionally throw a wrench into things, but if there was NS or something like that given during the Rocephin infusion, and there is no order for it, more than likely it was given to help flush the Rocephin through the system and it is not codeable. I have been coding infusions for years and I encounter that scenario more often than not - there is NS, or a similar bag, hanging and running before, during, and after the Antibiotic infusion. Unless there is a specific order to infuse it, then it was given as a "vehicle" for the antibiotic, so to speak.
I do agree that if there was no end time documented, then it needs to be coded as 96374, rather than 96365, and that to code 96365 it needs to be 16 minutes or longer infusion duration.
I hope this helps!


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