ED Coding and Reimbursement Alert

Question: A patient complaining of vomiting and stomach pain presents to the ED. The physician performs intravenous fluid hydration on the patient, administering normal saline solution through an IV. Total hydration time is 41 minutes. After performing the hydration, the ED physician performs a flush on the patient. Can the ED report the flush and the IV hydration on this claim?

Wisconsin Subscriber

Answer: The flush is not separately reportable, because CPT considers this service part of the work units for the IV hydration. On your claim:

- report 90760 (Intravenous infusion, hydration; initial, up to 1 hour) for the hydration.

- attach 787.03 (Vomiting alone) to 90760 to represent the patient's vomiting.

- attach 536.8 (Dyspepsia and other specified disorders of function of stomach) to 90760 to represent the patient's stomach pain. Remember: When you report IV hydration, the following services are bundled into 90760 and +90761 (... each additional hour [list separately in addition to code for primary procedure]):

- any use of local anesthesia

- placement of the IV line

- access to indwelling IV line, subcutaneous catheter or port

- flush at conclusion of infusion

- any use of tubing, syringes or other supplies.