Oncology & Hematology Coding Alert

Question:

Pennsylvania Subscriber

You should not report 96360-+96361 (Intravenous infusion, hydration ...) for saline administered concurrently with chemotherapy, according to Medicare.

Rule: "Medicare currently permits separate payment of HYDRATION therapy provided sequentially (but not concurrently) to CHEMOTHERAPY infusion," states your Pennsylvania Part B MAC, Highmark, in article A47797. (Search for the article here: www.cms.gov/mcd/search.asp.)

In addition, Medicare's Correct Coding Initiative (CCI) policy manual states, "Hydration concurrent with other drug administration services is not separately reportable" (chapter 11, section B.5).

What's reportable? The manual states, "If therapeutic fluid administration is medically necessary (e.g., correction of dehydration, prevention of nephrotoxicity) before or after transfusion or chemotherapy, it may be reported separately" (section B.4). You may download the manual at www.cms.gov/NationalCorrectCodInitEd/.

Note that non-Medicare policies may differ from Medicare's rules. Also, always reference the coding instructions and parenthetical notes for the administration services you are providing.