Wiki 20 minutes infusions

[mariadifuccia]

Can we bill for an hour infusion if the medication was infused for 20 minutes? For example, a patient comes in for scheduled chemotherapy and has 2 non-chemo medications infused prior to the chemotherapy. Both were infused for 20 minutes each at seperate times. Are we to bill for the hour infusion code or do we default to the IV push code?
Aslo, does anyone know how long a medication must be infused in order to bill for the "up to an hour" code.
Thank you for your help

 

[cgrussell]

That would depend on what drug was being administered. Check the code that you are billing with each drug. I believe "up to an hour" has to be at least 31 minutes. I'm not looking at my book but I would check the guidelines in the front section.

 

[hmassimino]

If the drugs are therapeutic, the infusion codes would be 96365 and 96367 for the "initial "and the "ea addl drug". Drugs that are infusion for 15 mins or less are considered pushes 96374 or 96375, anything over 15 mins is considered an infusion. Hydration is another story. If you are infusing saline for hydration alone, anything over 31 mins would be 96360, then after the first hour you would use 96361. This is for saline only, no drug has been introduced. If a drug is introduced you can not use the hydration codes.

Keep in mund that these codes all change once a chemo drug is introduced. This is strictly for threapeutic drugs.

Hope that helps a bit.

 

[alannae]

Therapeutic drugs (non-chemo) administered prior to chemo (same DOS) for 20 minutes each sequentially would be coded as 96367 x2 units. The chemo drug given after this (based on your question) would likely be billed with 96409 or 96413 (depending on the length of the infusion). The chemo drug's administration would be your primary/initial code for this encounter. You can only bill one initial code per encounter and it is always for the primary reason for the visit (ie the chemo).



Alanna, CPC

 

[hmassimino]

Therapeutic drugs (non-chemo) administered prior to chemo (same DOS) for 20 minutes each sequentially would be coded as 96367 x2 units. The chemo drug given after this (based on your question) would likely be billed with 96409 or 96413 (depending on the length of the infusion). The chemo drug's administration would be your primary/initial code for this encounter. You can only bill one initial code per encounter and it is always for the primary reason for the visit (ie the chemo).



Alanna, CPC

That's right Alanna, sorry I didn't read the drugs were administered before the chemo drug. You've explained it very well here.