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vjefcoats

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Good morning!

Patient comes to ED for altered mental status, patient admitted for observation
IV Sod Chloride 1000ml @ 150ml/hr on IV pump to Left wrist started at 1:00 and stops at 1:47
At 1:47 Sod chloride 1000ml @ 200 ml/hr lt wrist

2nd IV started sodium chloride @ 3:03 to right foot and continues thru departure at 5:25
at 4:47 Cipro IVBP is started right foot and continues thru departure @ 5:25

Disposition: pt admitted to OBS
IV fluids infusing well on IV pump 1000ml rate 200ml/hr amt infused 300 ml fluid shared with IVPB medication Cipro 400mg/200ml
IV fluid infusing well 200 ml rate 200 ml/hr amt infused 100 ml
departure to floor @ 5:25

How would you code this??
Thanks for your input
Vicki, CPC
 
Hi,

We can bill the above scenario as mentioned below:
96365 ( Cipro VBP-4.47 to 5.25)
96361 x 3 (NACL starts 1.00 to 1.47 & 3.03 to 4.47)
The NACL start @ 3.03 and run up to 5.25, however we need calculate upto 4.47 because of one IVBP was start to run @ 4.47 and ends @ 5.25 (NACL also @ 5.25).
We need to calculate hydration code based on hydration need to run exclusively without any mixture of any IVBP. If it infused along with any IVBP we less the time, then we calculate the running time of hydration.
If the IVBP and hydration were run in two different line example hydration in left wrist and IVBP in right leg at that time we don't need to less the hydration time because both are exclusive each other.
 
Thank you!

I appreciate your input! I coded it that way also but I'm having a difference of opinion with our EHR coding module!!!
 
I was always instructed that even if hydration is in its own line, it can not be billed as a concurrent infusion, therefore it needs to be billed only when there is no other infusion running, which would mean that you need to subtract out your IVPB time. From everything I have read, that is my understanding. If it is incorrect, please let me know where you find your information from as I would love to learn it differently.
 
infusions

hi,

Nacl infusing in two sites left wrist and right foot, and ivpb Cipro 400mg/200ml also infusing in right foot. We have to consider two different sites.
Lt wrist Nacl- 1.00 to 1.47 ----47 min
rt foot Cipro -4.47-5.25 min----38 min
rt foot nacl--3.03-5.25min-----2.22 min


final calculation :
96365
96361 *2
96360

I think it will helpful to you
 
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