# infusion/hydration



## JYSPA

I have a case with :
1411 - 1541 Levaquin ivpb
1605 - 1705 - Zosyn ivpb
1531 - 1601 - Amoxicilin ivpb
1541 - 1803 - Hydration
How do I code this? 

Thank you.
Jyotsna


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## msekarinfo

JYSPA said:


> I have a case with :
> 1411 - 1541 Levaquin ivpb
> 1605 - 1705 - Zosyn ivpb
> 1531 - 1601 - Amoxicilin ivpb
> 1541 - 1803 - Hydration
> How do I code this?
> 
> Thank you.
> Jyotsna




IVPB-
 1411 - 1541 Levaquin ivpb   -- 96365,96366 (One hour infusion one substance with additional hour)
1605 - 1705 - Zosyn ivpb      --96368(Infusion different substance concurrent intial substance)
1531 - 1601 - Amoxicilin ivpb--96367(Sequential infusion different substance given after intial infusion
Hydration-                           - -96361*2(Hydration 2 hou)r

Overall* 96365,96366,96367,96368,96361*2*


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## Mojo

msekarinfo said:


> IVPB-
> 1411 - 1541 Levaquin ivpb   -- 96365,96366 (One hour infusion one substance with additional hour)
> 1605 - 1705 - Zosyn ivpb      --96368(Infusion different substance concurrent intial substance)
> 1531 - 1601 - Amoxicilin ivpb--96367(Sequential infusion different substance given after intial infusion
> Hydration-                           - -96361*2(Hydration 2 hou)r
> 
> Overall* 96365,96366,96367,96368,96361*2*



If these infusions were administered via one site, I would code as 96365, 96367, 96368, 96361 since the Levaquin requires 91 minutes for the additional hour of 96366 to be assigned (per CPT report 96366 for infusion intervals of greater than 30 minutes beyond 1 hour increments).  Hydration cannot be reported concurrently and is captured after the Zosyn.


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## JYSPA

Thank you


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## msekarinfo

Mojo said:


> If these infusions were administered via one site, I would code as 96365, 96367, 96368, 96361 since the Levaquin requires 91 minutes for the additional hour of 96366 to be assigned (per CPT report 96366 for infusion intervals of greater than 30 minutes beyond 1 hour increments).  Hydration cannot be reported concurrently and is captured after the Zosyn.



yeah mojo i agree this....


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## kumeena

If there is no medical necessity for hydration I would not code for that. Eveything else is Ok with me.  To code for concurrent infusion it should be 2 different sites (RT and LT) documented in chart.


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## OCD_coder

1.  1411 - 1541 Levaquin ivpb  
3.  1605 - 1705 - Zosyn ivpb
2.  1531 - 1601 - Amoxicilin ivpb
4.  1541 - 1803 - Hydration

1.  90 minutes therapeutic drug  96365 
2.  20 minutes therapeutic drug  96367
3.  70 minutes therapeutic drug  96367
4.  58 minutes hydration            96361 only if documentation supports it

a.  You cannot bill for overlapping times on infusions when going through the same line into the patient.
b.  To bill a 2nd hour of infusion, it must meet the 91st minute, 96366 not billable for #1.
c.  IVPB means IV piggyback via one line into one hole into the patient; is defined as two drugs hung at the same time and gravity works to administer the drugs when the lower bag ends the second one starts; if they are the same type of drug they are coded as one infusion, see #2.
d.  Concurrent drugs are two different drugs that run at the same time, this is not occurring except with the overlap between the levaquin and amoxicillin for 10 minutes.  They also must run through the same line into the same hole into the patient to qualify for concurrent.  Otherwise, they are two separate infusions and two initial administration codes would be used.
e.  I agree that hydration needs to be carefully documented that the patient has one of the dx per the CMS NCD, hydration, nausea and/or vomiting, etc.  If the documentation states KVO (keep vein open) this is not a billable service.  The time hydration runs when a drug is run through the same line does not count towards any hydration coding.

I have a cheat sheet if anyone is interested, email me directly.


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## smbolden

*smbolden*



OCD_coder said:


> 1.  1411 - 1541 Levaquin ivpb
> 3.  1605 - 1705 - Zosyn ivpb
> 2.  1531 - 1601 - Amoxicilin ivpb
> 4.  1541 - 1803 - Hydration
> 
> 1.  90 minutes therapeutic drug  96365
> 2.  20 minutes therapeutic drug  96367
> 3.  70 minutes therapeutic drug  96367
> 4.  58 minutes hydration            96361 only if documentation supports it
> 
> a.  You cannot bill for overlapping times on infusions when going through the same line into the patient.
> b.  To bill a 2nd hour of infusion, it must meet the 91st minute, 96366 not billable for #1.
> c.  IVPB means IV piggyback via one line into one hole into the patient; is defined as two drugs hung at the same time and gravity works to administer the drugs when the lower bag ends the second one starts; if they are the same type of drug they are coded as one infusion, see #2.
> d.  Concurrent drugs are two different drugs that run at the same time, this is not occurring except with the overlap between the levaquin and amoxicillin for 10 minutes.  They also must run through the same line into the same hole into the patient to qualify for concurrent.  Otherwise, they are two separate infusions and two initial administration codes would be used.
> e.  I agree that hydration needs to be carefully documented that the patient has one of the dx per the CMS NCD, hydration, nausea and/or vomiting, etc.  If the documentation states KVO (keep vein open) this is not a billable service.  The time hydration runs when a drug is run through the same line does not count towards any hydration coding.
> 
> I have a cheat sheet if anyone is interested, email me directly.



I would love to have your cheat sheet.  However, I don't know what your email is.  If you could email me directly at showard2@r1rcm.com, I would greatly appreciate it!


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## jacquelinc

OCD_coder said:


> 1.  1411 - 1541 Levaquin ivpb
> 3.  1605 - 1705 - Zosyn ivpb
> 2.  1531 - 1601 - Amoxicilin ivpb
> 4.  1541 - 1803 - Hydration
> 
> 1.  90 minutes therapeutic drug  96365
> 2.  20 minutes therapeutic drug  96367
> 3.  70 minutes therapeutic drug  96367
> 4.  58 minutes hydration            96361 only if documentation supports it
> 
> a.  You cannot bill for overlapping times on infusions when going through the same line into the patient.
> b.  To bill a 2nd hour of infusion, it must meet the 91st minute, 96366 not billable for #1.
> c.  IVPB means IV piggyback via one line into one hole into the patient; is defined as two drugs hung at the same time and gravity works to administer the drugs when the lower bag ends the second one starts; if they are the same type of drug they are coded as one infusion, see #2.
> d.  Concurrent drugs are two different drugs that run at the same time, this is not occurring except with the overlap between the levaquin and amoxicillin for 10 minutes.  They also must run through the same line into the same hole into the patient to qualify for concurrent.  Otherwise, they are two separate infusions and two initial administration codes would be used.
> e.  I agree that hydration needs to be carefully documented that the patient has one of the dx per the CMS NCD, hydration, nausea and/or vomiting, etc.  If the documentation states KVO (keep vein open) this is not a billable service.  The time hydration runs when a drug is run through the same line does not count towards any hydration coding.
> 
> I have a cheat sheet if anyone is interested, email me directly.




****  I would also love to have a copy of your cheat sheet.  My email is JacquelinCPC@aol.com.  Thank you so much!! ******


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## hbarney1

Quote Originally Posted by OCD_coder View Post 

1. 1411 - 1541 Levaquin ivpb 
 3. 1605 - 1705 - Zosyn ivpb
 2. 1531 - 1601 - Amoxicilin ivpb
 4. 1541 - 1803 - Hydration

 1. 90 minutes therapeutic drug 96365 
 2. 20 minutes therapeutic drug 96367
 3. 70 minutes therapeutic drug 96367
 4. 58 minutes hydration 96361 only if documentation supports it

 a. You cannot bill for overlapping times on infusions when going through the same line into the patient.
 b. To bill a 2nd hour of infusion, it must meet the 91st minute, 96366 not billable for #1.
 c. IVPB means IV piggyback via one line into one hole into the patient; is defined as two drugs hung at the same time and gravity works to administer the drugs when the lower bag ends the second one starts; if they are the same type of drug they are coded as one infusion, see #2.
 d. Concurrent drugs are two different drugs that run at the same time, this is not occurring except with the overlap between the levaquin and amoxicillin for 10 minutes. They also must run through the same line into the same hole into the patient to qualify for concurrent. Otherwise, they are two separate infusions and two initial administration codes would be used.
 e. I agree that hydration needs to be carefully documented that the patient has one of the dx per the CMS NCD, hydration, nausea and/or vomiting, etc. If the documentation states KVO (keep vein open) this is not a billable service. The time hydration runs when a drug is run through the same line does not count towards any hydration coding.

 I have a cheat sheet if anyone is interested, email me directly.


jacquelinc ,

I just saw your post and if you can email me the cheat sheet please? hbarney2017@gmail.com

Much appreciated


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## racheljonestn@yahoo.com

*To OCD coder*

I would love a copy of your cheat sheet. racheljonestn@yahoo.com.


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## BENKA12!

OCD_coder said:


> 1.  1411 - 1541 Levaquin ivpb
> 3.  1605 - 1705 - Zosyn ivpb
> 2.  1531 - 1601 - Amoxicilin ivpb
> 4.  1541 - 1803 - Hydration
> 
> 1.  90 minutes therapeutic drug  96365
> 2.  20 minutes therapeutic drug  96367
> 3.  70 minutes therapeutic drug  96367
> 4.  58 minutes hydration            96361 only if documentation supports it
> 
> a.  You cannot bill for overlapping times on infusions when going through the same line into the patient.
> b.  To bill a 2nd hour of infusion, it must meet the 91st minute, 96366 not billable for #1.
> c.  IVPB means IV piggyback via one line into one hole into the patient; is defined as two drugs hung at the same time and gravity works to administer the drugs when the lower bag ends the second one starts; if they are the same type of drug they are coded as one infusion, see #2.
> d.  Concurrent drugs are two different drugs that run at the same time, this is not occurring except with the overlap between the levaquin and amoxicillin for 10 minutes.  They also must run through the same line into the same hole into the patient to qualify for concurrent.  Otherwise, they are two separate infusions and two initial administration codes would be used.
> e.  I agree that hydration needs to be carefully documented that the patient has one of the dx per the CMS NCD, hydration, nausea and/or vomiting, etc.  If the documentation states KVO (keep vein open) this is not a billable service.  The time hydration runs when a drug is run through the same line does not count towards any hydration coding.
> 
> I have a cheat sheet if anyone is interested, email me directly.



hello,
i would love to receive the copy of your cheat sheet also. my email is bpopowicz1@sbsglobal.net   thank you so much. benka


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