ED Coding and Reimbursement Alert

Reader Questions:

Remember, Hydration Codes Won't Hold Water With Payers

Question: A 94-year-old nursing home patient arrives to the ED via ambulance after her gastrostomy tube fell out; the emergency medical technician (EMT) informs the physician that the patient has been complaining of extreme thirst. During the examination, the physician diagnoses dehydration, and discovers the patient has missed several doses of antibiotics for a urinary tract infection (UTI). The physician orders labs, conducts a 34-minute intravenous rehydration, administers the necessary antibiotics, and evaluates the G tube site; notes indicate a level-four E/M. Then, she replaces the patient's G tube (no mention of imaging or guidance). Can I report the hydration separately for this patient?Minnesota SubscriberAnswer: The hydration service is not reportable on the professional side in the ED. On the claim, report the following:43760 (Change of gastrostomy tube, percutaneous, without endoscopic imaging or endoscopic guidance) for the G tube replacementV55.1 (Attention to artificial openings; gastrostomy) appended to 43760 to represent [...]
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