Oncology & Hematology Coding Alert

Question: We were denied payment for HCPCS code J7050 (Infusion, normal saline solution, 250 cc) for normal saline solution infusion 250cc (3 units of service). We had insufficient documentation to support that this infusion was for hydration. In the chemotherapy flow sheet, the physician recorded that the medications administered were mixed in the normal saline and administered via the normal saline.

Answer: You are facing a denial as there is insufficient documentation to support hydration. You as such report only fluids used for hydration. If your physician administered the saline to facilitate the chemotherapy infusion or injection, the saline is not separately payable.

Remember: You report hydration codes to report a hydration IV infusion which consists of a pre-packaged fluid and/or electrolytes (e.g. normal saline, D5-1/2 normal saline +30 mg EqKC1/liter). You cannot report hydration codes when the fluids are used for infusion of drugs or other substances.

If your physician ordered hydration, and the staff administered fluids solely for the purpose of hydration and the supporting condition for the hydration being infused, the same should be documented in the chemotherapy sheet.