Wiki Bill for IV hydration & IV med push at same time?

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maryperry

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In an Urgent Care setting; Can we bill cpt-96360 (IV hydration) and for cpt-96374-with mod 59 (medication push) together? We are getting the hydration code 96360 denied by insurance but the patient was dehydrated and then after hydration was given meds through a push 96374. Both services were rendered, so we should get paid for both??

thank you for any help!!
 
Hydration

You can use only one inital service code per encounter. The push would be the inital code and the for the hydration use each add. hrs- 96361

Hope that helps
Good Luck
 
IV Hydration.

96374 would be your inital code. The push, and then you could code for the hydration as additional 96361. A drug always takes Precedence over the hydration

When may we bill hydration?
A8. Documentation must indicate that the hydration service is a) medically reasonable and necessary and should include the rate of infusion and b) not an integral part of another service such as an operative procedure. When fluids are used solely to administer drug(s) or other substances, the administration of the fluid is incidental hydration and should not be billed.
If medical necessity requirements are met, hydration must be administered for more than 30 minutes for coding of hydration as an initial service. Hydration of 30 minutes or less is not separately billable.

What is the difference between an IV push and an infusion?
A4. An intravenous push (intravenous injection) is an infusion of 15 minutes or less. In order to bill an intravenous infusion, delivery must require more than 15 minutes for safe and effective administration.
 
Last edited:
maryperry said:
Sorry but I'm still confused. Can you bill 96360 with 96374?
thanks again!
Click to expand...

No, you can not. These are both "initial" codes and only one initial code can be coded per encounter. You will still get paid for both, you just have to use the "subsequent" hydration code which is 96361 with your 96374. You won't need a modifier with this code. Injection/infusions are really, really tricky. I found a lot of help in these forums learning about it so hang in there.
 
We are having the same problem here in my office. But our issue is documentation. So my question is this: If a start and end time is documented but the rate is wide open and only 1L is documented as the total amount infused, can this be billed still?:confused:
 
At a minimum documentation must show

what fluid was dripped---NS, ringers, etc

How many bags and size---Does 1L mean 1 bag or 2-500 bags?

start and stop time of the drip ---piggy back can stay until discharge. Need the drip time not the IV time

Drugs---were they pushed, dripped etc? And what was the dose and what time were they given (not ordered)
 
96360 hydration

Provider is charging 96360. Documentation states: "The IV infused over 45 minutes. I do not have exact start and stop times. This was done during the office visit."
Is this enough to support 96360?
 
Hydration Codes

We occasionally get patients who need hydration services in our clinic. in some cases the patient needs to be transported to a hospital with the IV line open. We usually dont bill for the hydration even if they were in our office for an hour (for hydration) because we do not have an end time. Would this be correct?
 
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