Oncology & Hematology Coding Alert

Question: The oncologist often orders a 35 minute intravenous infusion of Phenergan with a 250-cc bag of common saline solution for patients with diarrhea and vomiting. Should I report hydration and therapeutic drug administration?

Maine Subscriber

Answer: Stick to drug infusion code 96365 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; initial, up to 1 hour) in this situation. You should not report the hydration separately.

Here's why: CPT states that fluid used to administer the infusion of a drug is -incidental hydration- that you cannot report separately. And in the situation described, the provider administers the drug through the same IV. If you report both hydration and 96365, auditors will ask you for a refund.

Don't forget: Report the medication (J2550,Injection, promethazine HCl, up to 50 mg) if your practice bore the cost of the Phenergan.