Oncology & Hematology Coding Alert

Question: Can I code for hydration if it takes place at the same time as other medicines? For example, what are the proper codes when the patient's chemotherapy treatment followed this schedule?

- 9:30-11:30 am--Hydration therapy

- 9:30-10:02am--Dexamethasone IV

- 10:15-11:30 am--Gemzar chemotherapy infusion.


Pennsylvania Subscriber


Answer: CPT states that you shouldn't separately code for fluid used to administer the drugs, because it is incidental hydration. Translation: Don't code for the -flush bag- run to keep the line open.

You typically only code hydration for patients whose primary reason for presenting is the need for hydration. Unless your documentation specifically reflects this, you probably shouldn't code the hydration separately.

Use these codes for your case:

1. Assuming the chemotherapy infusion is the primary reason for the patient's visit, report 96413 (Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug). Payers are less likely to cover hydration when chemotherapy is the primary reason for the visit. Hydration patients typically experience symptoms that make treatment urgent or emergent.

2. Report the Gemzar with HCPCS code J9201 (Gemcitabine HCl, 200 mg) and the appropriate number of units.

3. Report the 32-minute dexamethasone IV with the subsequent code +90767 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; additional sequential infusion, up to 1 hour [list separately in addition to code for primary procedure]).

4. Report the dexamethasone with the proper code, such as J1094 (Injection, dexamethasone acetate, 1 mg) and the correct number of units.