Oncology & Hematology Coding Alert

Question: How should I code for an infusion of Dexamethasone (20 minutes) and two subsequent one-hour saline infusions, which also included magnesium and potassium, which were not premixed? The Dexamethasone was for nausea with vomiting and was the primary reason for the patient's visit. The saline mix was for volume depletion. We don't code for the drugs.


Illinois Subscriber


Answer: You should report 90765 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; initial, up to 1 hour) for the Dexamethasone infusion.

Before you report the saline infusion, remember that if the provider adds any substance to a pre-packaged fluid, the infusion becomes a therapeutic infusion instead of being hydration.

Because the provider added magnesium and potassium to the saline, you should not report hydration codes for these infusions. Report +90767 (... additional sequential infusion, up to one hour) for the first hour and +90766 (... each additional hour, up to 8 hours) for the second hour.

Attach diagnosis code 787.01 (Nausea with vomiting) for the Dexamethasone infusion and 276.5x (Volume depletion) for the saline mix infusion. ICD-9 2006 requires you to choose among 276.50 (Volume depletion, unspecified), 276.51 (Dehydration), and 276.52 (Hypovolemia).