# Infusions started in ER



## whittakermarie@yahoo.com (Aug 27, 2012)

When an infusions is started in the ER and the patient is then moved to outpatient observ or admitted to hospital what would be used for the stop time for the infusion that was started in the ER?


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## cinco111 (Sep 5, 2012)

*IV infusion and in-system transfers...*

If an IV infusion  is started in the ED of one facility in a health system and the patient is transfered to another ED in the same health system, can the infusion be coded for both facilities if the time is sufficient?

THANKS!


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## JulesofColorado (Sep 6, 2012)

We use the time the patient became an inpatient as the stop time.


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## charissesimone (Sep 13, 2012)

whittakermarie@yahoo.com said:


> When an infusions is started in the ER and the patient is then moved to outpatient observ or admitted to hospital what would be used for the stop time for the infusion that was started in the ER?


Per CPT guidelines the start time is the time infusions began infusing on the IV machine and the STOP is the the infusions stop infusing on the IV machine.  For example: Patient comes in to ER from a head injury from a MVA( motor vehicle accident), doctor order pain medication to be infused. The coder would code the Trauma , the E Codes, and the infused drugs m HCPCS J- Codes. 
The patient began infusions @ 12:00 hrs- 14:00 hrs - that is your start and stop time- so it would be like CPT codes 96365, 96366 (additional same drug) or 96376 (new/different drug) unless it hydration drugs (d5w, KCL, Lactate ringers) you code the hydration ( 96360, 96391( additonal hr), if the hydration are mixed with the regular drugs(ancef, toradol, phergan) then it would be a therapy and codes as 96365, and so. Remember also you can only code 1 intial service CPT code 96365, 96361, 96374 not all together. But if you have the intial code 96365, then code the other codes 96366, 97375, 97376. examples.. Inbox me for help. I work also an Auditor and Coder as I coded for many specialties or find me on linkedin.com/charissesimon. Good Luck


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## charissesimone (Sep 13, 2012)

JulesofColorado said:


> We use the time the patient became an inpatient as the stop time.


@ Jules of Colorado.  As a rule of thumb.. You need want to code any infusions based off when patient admitted to hospital. That would be considered a "RAC Target/OIG Red Flag as that is not following proper protocols in which your hospital could be audited let alone coders getting in trouble for improper coding. 

Infusions is based off time, type of drug, reason for being infused(hydration, infection, post surgery,chemotherapy) and a order by the physician -documented in pt's chart. If infusion(s) not having a documentation of any start & stop time per MediCare -it can jeopardize patient care.  Any hospital professional & patient needs to know how much is being infused due to some patients can't tolerate certain meds. So it's critical to know what your doing to that patient's care. If your NOT Properly trained in coding infusions.. it's best to ask your more experience colleagues for training or take up educational courses in areas your skill levels may be lacking.


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## JulesofColorado (Sep 29, 2012)

charissesimone let me clarify. I didn't mention that we only use the stop time when patient becomes an inpatient if there is specific documentation that the med is still infusing. I have been properly trained, thank you. 

charissesimone Quote:
Originally Posted by JulesofColorado  
We use the time the patient became an inpatient as the stop time. 

@ Jules of Colorado. As a rule of thumb.. You need want to code any infusions based off when patient admitted to hospital. That would be considered a "RAC Target/OIG Red Flag as that is not following proper protocols in which your hospital could be audited let alone coders getting in trouble for improper coding. 

Infusions is based off time, type of drug, reason for being infused(hydration, infection, post surgery,chemotherapy) and a order by the physician -documented in pt's chart. If infusion(s) not having a documentation of any start & stop time per MediCare -it can jeopardize patient care. Any hospital professional & patient needs to know how much is being infused due to some patients can't tolerate certain meds. So it's critical to know what your doing to that patient's care. If your NOT Properly trained in coding infusions.. it's best to ask your more experience colleagues for training or take up educational courses in areas your skill levels may be lacking.


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## CS (Oct 2, 2012)

Jules of Colorado, I understood what you meant.  I would never assume you meant that that was the only criteria you used.  I think it is because of responses like this (implying that you are not properly trained) that some questions are viewed 100 times and never replied to.


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## JulesofColorado (Oct 2, 2012)

Thank you CS! I totally agree with you!


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