Coding Corner: Follow These 3 Expert Tips and Master the New Infusion Codes

Time documentation is the key to choosing the right code

If the 2006 CPT changes to infusion and injection coding are giving you frequent headaches, you’re not alone. Take a look at the advice from coding experts to figure out when you can’t report hydration services, why accurate timekeeping is essential, and much more.
Use Separate Codes to Report Hydration Therapy
CPT 2006 replaces all seven previous codes for therapeutic, diagnostic or prophylactic injections and infusions with 11 new codes.
Old way: Last year, CPT included intravenous hydration infusion services within two general infusion codes (90780 and 90781) that reported all therapeutic or diagnostic infusions except for chemotherapy, says CPT Changes -- An Insider’s View.
New way: Now you will be able to specifically identify hydration services using new codes 90760 (Intravenous infusion, hydration; initial, up to 1 hour) and +90761 (... each additional hour, up to 8 hours [list separately in addition to code for primary procedure]).
If you’re reporting C codes, on the other hand, there is no separate code for hydration, says Cindy Parman, CPC, CPC-H, RCC, co-owner of Coding Strategies Inc. in Powder Springs, Ga. Instead, use the new C code C8950 (Intravenous infusion for therapy/diagnosis; up to one hour) or for additional hours, use  C8951 (... each additional hour).
While the new codes allow for more specificity of services reported, they also help separate true hydration services from incidental hydration such as flush bag or KVO infusions, Parman says.
Exception: While most hydration services are now separately reportable, CPT states that fluid used to administer the infusion of a drug is incidental hydration that you cannot report separately.
Keep Track of Start and Stop Times
Stop and start times have always been important when coding infusions, but they are even more critical now, says Sarah L. Goodman, MBA, CPC-H, CCP, president of SLG Inc. in Raleigh, N.C.
Caution: Don’t be tempted to round up infusion time -- every minute counts, Parman says. “Especially since 15 minutes is an intravenous push and 16 minutes is an infusion,” she says.
Old way: In the past, you had to use an add-on code to report extended infusion time, or when the physician administered an additional infusion. “Reporting for additional sequential infusion services was indistinguishable from additional hours of infusion,” CPT Changes 2006 says.
New way: Now you have “secondary service” codes, or add-on codes, to report additional sequential infusions, sequential IV pushes, and IV chemotherapy pushes. CPT instructs that you must report all of these codes separately in addition to the initial infusion code. The new codes are:

• +90767 -- Intravenous infusion, [...]

- Published on 2006-06-14