# infusion or hydration



## tuffy1

I am learning to code E/M and ER charges.  I am having a problem knowing what is an infusion or just an IV or hydration.  Is there a site or anything out there that can tell me what was given is an infusion or hydration?  For example all I get is: D5 and the route is IV and total infusion is done in so much time. D5 does not tell me anything.  Is there a book or web site or software that could help me to understand?  Any suggestion please!!!!!!


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## srburk

*Hang in There*

IV hydration and IV infusions are hard.  If you will contact me via email I will get back to you when I get to work on Monday and give you a cheat sheet that has the guidelines.  I have attended several webinars and spent the last two years reading everything I could get my hands on and the girls in my office wrote up our cheat sheet and i think it will help you.   FYI.  D5 is a type of fluid that they are hanging in a bag so what you are currently dealing with is a hydration. If they are talking about a medicine you will need to know whether or not they are administering it via IV Push or Piggyback to determine how to code the infusions and hydrations.  PM me and I will get back to you.    Suzette.


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## tuffy1

I sent you a private message and gave you my e-mail address.  Any help you can give me is very much appreciated.  Thank you again srburk.


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## rebecca.zeeryp

can you please send me all the information you have regarding infusion and hydration guidlines. we are really confuse on how to code these and get proper reimbusersement. thanks in advance. rgzeeryp


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## ctodicheeney

*Infusion Confusion*



srburk said:


> IV hydration and IV infusions are hard.  If you will contact me via email I will get back to you when I get to work on Monday and give you a cheat sheet that has the guidelines.  I have attended several webinars and spent the last two years reading everything I could get my hands on and the girls in my office wrote up our cheat sheet and i think it will help you.   FYI.  D5 is a type of fluid that they are hanging in a bag so what you are currently dealing with is a hydration. If they are talking about a medicine you will need to know whether or not they are administering it via IV Push or Piggyback to determine how to code the infusions and hydrations.  PM me and I will get back to you.    Suzette.


Can you please include me in on that FRI cheatsheet I am having the same misunderstanding of that procedure and whether to add the J7030/J7050 and J7613 or A4216/A4217???....Help@ctodicheeney@yahoo.com


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## Stefanie

me too please.  scramer@colmtmed.com


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## cobin

*Me as well.  cobin@partners.org*

Me as well.  cobin@partners.org


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## DUEEAST

Would you please send me a cc of the cheat sheet?


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## mitchellde

FYI  D5 is a shorten term meaning D5W which is a 5% dextrose solution in water and is oftern given as a primary fluid for hydration but only to non diabetics, NS is a normal Saline solution also hung as a primary solution for hydration.  To code IV hydration first of all you need a dx to support hydration, sometimes a primary fluid is hung just to KVO which is keep vein open , this is not for hydration purposes it is for convenience should they decide to push a drug or a secondary solution.   Interqual criteria states to be therapeutic the rate must be at least 125cc per hour, otherwise it is for convenience.  I always tell my students when coding for infusions, remeber the codes come as initial and subsequent types you can charge only one initial service if only one vein is accessed.  So you may have initial therapeutic infusion then if the situation changes and they decide to hydrate the patient you would use subsequent hydration.  If 2 veins are accessed then you will need a 59 modifier to charge for 2 inital services.  I hope this helps to clear up some of it.


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## rodriguj

I too, would love to see a copy of your "cheat sheet!":


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## mlillard

I would appreciate a copy of that cheat sheet also.  Infusion and hydration are a very difficult coding problem.

Thanks,

Marilyn


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## smilenithya

HI I am also new to coding Infusion and Hydration. Can you help with your copy of cheat sheet regarding infusion and hydration. My mail Id is smilenithya@gmail.com.

Thanks
Nitya


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## StephanieBurnett

*Cheat Sheet*

Would love a copy of the cheat sheet as well please. stephanie.burnett@nortonhealthcare.org


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## reynerafoth

i would also love to have a copy of your cheat sheet ...thanks much


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## LTibbetts

Is anybody actually getting a copy of this sheet from anyone? If someone has a second, can you please send it on to me as well?

leslie.tiibbetts@bhmh.org


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## Beth Neitz

*Ban*

Does anyone have any written criteria as to the documentation guidelines required by nursing staff?  Our ED Nursing staff refuses to document start and stop times and I am in need of billing guidelines. 

I too would like a copy of your cheat sheet. baneitz@geisinger.edu


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## kumeena

please add my name too for cheat sheat.My E-mail address is kumarm@nychhc.org

Thank U


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## Eena

Can this cheat sheet be posted to the Forum?  If not, can I be added to the growing list who are requesting it?  This has become a hot topic this week at our facility.


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## viswaas

*96360 payable icd list and modifier specific*



ctodicheeney said:


> Can you please include me in on that FRI cheatsheet I am having the same misunderstanding of that procedure and whether to add the J7030/J7050 and J7613 or A4216/A4217???....Help@ctodicheeney@yahoo.com



Hi,

I have seen the details you have specified in the forum but could you help me to get reimbursement for cpt 96360 iv fluid and is there any LCD and modifier Specific for this service,  please help me to find a solution.  My email ID: viswaas@yahoo.com

Viswaas


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## ansada

please send me a copy of your cheat sheet also ansada@atlanticbb.net


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## skylerstigger

I would also like a copy of your cheat sheet.


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## DoDCoder4You

IV infusion / Hydration / IVP is quite Simple once you get it down.

IVP (IV Push) is less than 15 mins 
1st Drug 96374
 Each addional sequential push of new drug) 96375
 Each additional sequential push same drug (must be given over 30 mins after initial push) 96376

IV Hydration must run over 31 mins to 1hr  96360
  Each additional hour of Hydration 96361 ( report for intervals of greater than 30 mins beyond 1st hour increment)
Hydration is considered Normal Saline, ect

IV Therapeutic Medicinal Drug
 must run over 15 mins to 1 hour 96365
    Each additional hour greater than 30 mins beyond 1st hour increment) 96366

96367 Additional Sequential Infusion up to 1 hour ( for a differant initial service admin through the same IV access)
Report only ONCE per sequential infusion of same infusate mix.

96368 Concurrent infusion - List only once per encounter (A concurrent infusion is one in which two drugs are simultaneously infused or multiple infusions are provided through the same intravenous line


I can break it down for you even farther if you would
like me too, i did Infusions for 3 yrs in the Emergancy room Setting.


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## southbaymed

*Please give copy to me*

Please give the copy ;  southbaymed@hotmail.com


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## wahmcoder

I would love  a copy too. samanthashupe@gmail.com


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## DoDCoder4You

I found this today, its a copy of a webpage.

It may help some.

Copyright © 2008 by American Society of Clinical Oncology.
Concurrent Infusions
ASCO's Coding and Reimbursement Hotline continues to receive questions regarding concurrent infusions. In 2006, the current procedural terminology (CPT) Editorial Panel created a specific code, 90768, for concurrent infusions of nonchemotherapy drugs or substances. The questions and answers in this article are designed to provide additional information and clarification regarding the use of the concurrent drug administration code. 

What is a concurrent infusion?

A concurrent infusion is one in which two drugs are simultaneously infused or multiple infusions are provided through the same intravenous line. 

If a second drug is added to a bag for intravenous administration, can the administration of the second drug be reported?

No. More than one substance in a single bag is considered one infusate and one infusion. In this scenario, only one administration can be reported. However, the J-code for each substance or drug would be separately reportable. 

If two drugs are infused simultaneously but hang in separate bags, is this considered a concurrent infusion?

Yes. If multiple drugs are hung separately but run simultaneously, the administration is considered to be concurrent. In this situation, you would report an initial or subsequent administration (depending on your identified primary service) for the first drug, and a concurrent administration for the second drug. 

What if two drugs are mixed in the same bag and administered for only 15 minutes?

An infusion of 15 minutes or fewer is defined as a push, and the appropriate push code (initial or subsequent) should be reported. In this situation, the infusion would be reported as one push; however, each substance or drug would be separately reported. 

Can more than one concurrent administration code be reported?

The CPT book provides clear guidance that concurrent infusion can be billed only once per patient encounter. 

The Coding and Reimbursement Hotline receives many questions relating to the administration of leucovorin with an antineoplastic agent such as fluorouracil. Leucovorin is used in some chemotherapy regimens to enhance the antineoplastic effect; however, Medicare carriers, fiscal intermediaries, and/or Medicare Administrative Contractors have the discretion to determine whether the administration of leucovorin should be reported as a nonchemotherapy or chemotherapy administration. 

http://jop.ascopubs.org/content/4/4/171.full


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## Nandhakumar007

Its useful


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## Nandhakumar007

Its really useful


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## lauriepaul1115

I saw the post about the cheat sheet for the IV therapy hydration.  I would love a copy if possible.  I am new to this and am struggeling.  Thanks  mcauley1115@gmail.com  I would greatly appreciate it.


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## ptrautner

you  need to determine if it is incidental hydration


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## SLB1025

Hi, 
Can I get a copy of your cheat sheet as well? My email address is boydso@yahoo.com.

Thanks!


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## Sueedwards

*Cheat Sheet*

Suzette, I would love a copy of your cheat sheet. 
thanks, Sue


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## losborn

I would like the cheat sheet as well:  lkosy1@yahoo.com

Thanks

Lin


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## arojas123

*cheat sheet*

would you please share with me your cheat sheet. I am taking the CPC exam on Dec 10/11.

Thanks,


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## ivorytofu@hotmail.com

*Infusion/Hydration coding*

anyone still have a copy of this cheatsheet?  Could someone please send me a copy?

asimscpc@gmail.com

thanks


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## Elizabeth G

I would also love a cheat sheet as I am new to ED coding also. If there is still one out there.

email @
e.godden83@gmail.com


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## Sharon CPC CEMC

I came across your infusion post response and was wondering if you may have an updated cheatsheet you could share, the post was from 2009 I believe  or anybody?
It would be greatly appreciated!

Thanks in advance!!!
Sharon

sbeltowski@aol.com


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## alices

*infusions*

if it isn't too late to ask and you aren't tired of sending to everyone can you please include me with a copy of it I would really appreciate it..thanks, alice
asalcido@sjgh.org thank you


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## cinco111

*Cheat sheet for Infusion Therapy...*

I, too, saw this kind offer and would love a copy if it is still circulating.  My email address is asksusancoding@bellsouth.net.  THANK YOU!


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## codeds07

*IV cheat sheet*

Hi Srburk
Tried to send you a private message but your inbox is full, could you please forward a copy of your IV cheat sheet to my e-mail? would truly appreciate it!

Thanks 
donna s.
dsimba2002@comcast.net


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## akonyk

*Cheat sheet*

I would also love to have a copy of the IV / Infusion cheat sheet you have referred to. My email is akonyk@gmail.com

Thank you so much for all the info you have already provided.


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## DebbieChicoine

Hi 
I saw your post and would like to get a peek at that cheat sheet as well.
I would appreciate any help you can give.

I had a patient today that was seen at 8am for hydration and again at 8pm for hydration, can I bill two initial hydrations on the same day or should I bill for the second one a each add'l hydration ?
Someone had told me I could bill two initials with a modifier 76, is this accurate?

Again Thanks for any help you can give me
Debbieinnaples@aol.com


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## skelly

*Infusion Cheat Sheet*

I would also like a copy of a cheat sheet for Infusions and Injections.  Please email me at 

skelly01@harthosp.org.  

Thanks,

Sue


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## kumeena

srburk said:


> IV hydration and IV infusions are hard.  If you will contact me via email I will get back to you when I get to work on Monday and give you a cheat sheet that has the guidelines.  I have attended several webinars and spent the last two years reading everything I could get my hands on and the girls in my office wrote up our cheat sheet and i think it will help you.   FYI.  D5 is a type of fluid that they are hanging in a bag so what you are currently dealing with is a hydration. If they are talking about a medicine you will need to know whether or not they are administering it via IV Push or Piggyback to determine how to code the infusions and hydrations.  PM me and I will get back to you.    Suzette.



Yourmail box is full. i could not send you private message. 

Please send  me a copy of the cheat sheet and other resources.

meenakumarcoder@yahoo.com


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## tflint1

*Infusion Cheat Sheet*

Can you include me as well
t.silas@yahoo.com


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## papitrolo

*Cheat Sheet for Infusions and Injections*

Could you please send me a copy of the I & I cheat sheet.  I would really appreciate it.

papitrolo@gmail.com


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## jodilynpierce

*Cheat sheet*

Could you please also send a copy of the cheat sheet to jlpierce29@centurytel.net. Thanks so much!


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## second to none 

Please, can you send me a copy of that sheet. I also have a request to the coders and students who already recieved the copy of sheet, please share it with other coders and students. My email is mapleflower84@hotmail.com.


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## dgribben

*cheat sheet*



srburk said:


> IV hydration and IV infusions are hard.  If you will contact me via email I will get back to you when I get to work on Monday and give you a cheat sheet that has the guidelines.  I have attended several webinars and spent the last two years reading everything I could get my hands on and the girls in my office wrote up our cheat sheet and i think it will help you.   FYI.  D5 is a type of fluid that they are hanging in a bag so what you are currently dealing with is a hydration. If they are talking about a medicine you will need to know whether or not they are administering it via IV Push or Piggyback to determine how to code the infusions and hydrations.  PM me and I will get back to you.    Suzette.



I would love to have a copy of the cheat sheet. Please e-mail it to me
dgribben@communityhoward.org
Thank you.


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## lyokota@hhsc.org

*infusion/hydration*

could you please send me a cheat sheet on infusion,hydration.  I would appreciate it.


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## suela923@aol.com

Hello!  Would it be possible to get a copy of your cheatsheet....it sounds great!

if so....slahood2@lghealth.org

Thanks!!!
Sue


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## jackiemal

I would really love a copy of the cheat sheet as well.  If anyone still has this, can you please email me a copy as well.  I too have tried to email and the mailbox is full.
Please, please, please send me a copy.  
jackielmal@gmail.com


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## maddismom

The original post is from 2009, so there's probably a good chance the email address is no longer valid.


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## mvalle123 COC CPC

hi just saw this post I would like a copy of your cheat sheet too. thank you 
mvalle@graybill.org


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## cgillespie

*iv cheat sheet*

I would like a copy of the cheat sheet if possible.  I think I got it except I am questioning myself on 96366 especially on the facility charging for example when i have an observation chart example:

zithromax ivpb today from 9-10 = 96365 x 1
then its given again today from 1-2 is this 96366 x 1 or does it have to be the 30 minutes greater than one hour after its given from the 9-10???

Can you send me a copy of your cheat sheet I would much appreciate it

my email ccgillespie@windstream.net


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## spinner1959

I as well would like the cheat sheet. Am struggling with infusion add on codes and reporting the primary each day.
thank you
Deb
dpinner@aetna.com


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