ED Coding and Reimbursement Alert

Question: When a patient receives multiple injections and infusions, how do I determine which service to assign the -initial- code? For instance, a patient comes in with nausea and vomiting and receives IV hydration and an IV of Zofran. Do I use the -initial- code to describe the IV, or the infusion? 


Connecticut Subscriber


Answer: Frequently in the emergency department, the clinical situation of the patient will support the use of the hydration (90760, Intravenous infusion, hydration; initial, up to one hour) as the initial service, and the injection or infusion of the medication (+90766, Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; each additional hour, up to 8 hours [list separately in addition to code for primary procedure]) as a subsequent service.

This is not a hard-and-fast rule, but would be based on the clinical parameters of the particular visit.