I was researching previously created threads related to the correct billing of CPT 96360 and 96361 and found some helpful threads from back in 2014, however I have some additional questions in regards to the billing of CPT 96360 and 96361, specifically related to non-continuous hydration infusions...
My claim example:
Documentation supports an initial order for a 1L NS bolus. This bolus was administered from 1005-1135 and stopped once completed (for a total of 90 minutes). The patient was still symptomatic, so a separate order for an additional 1L NS bolus was made. The 2nd NS bolus was given from 1140-1255 (for a total of 75 minutes) on the same date of service.
The provider billed 96360 x1 unit and 96361x2 units. So I am assuming they added the total time between the two infusions which totaled 165 minutes and then broke that down by 60 minutes intervals to get 1 unit of 96360 billed and 60 minutes for the first unit of 96361 and 45 minutes for the 2nd unit of 96361.
My thoughts are that the claim should be billed with 1 unit of 96360 for the initial 90 minute NS infusion and 1 unit of 96361 for the subsequent 75 minutes NS infusion. My understanding is that for this specific scenario we should not be adding these two infusion times together since the infusions were truly not continuous (had separate orders for 2 different boluses and stopped between infusions- and not just for a bag change) and the two infusions should remain separate for purposes of calculating the times for each infusion since the 2nd infusion was subsequent to the initial infusion. Does this sound correct? Or regardless if the infusions administered are continuous with one another or not, would we just add up the total infusion time (as long as the infusion intervals are greater than 30 minutes)?
Clarification would be greatly appreciated. Thank you!
My claim example:
Documentation supports an initial order for a 1L NS bolus. This bolus was administered from 1005-1135 and stopped once completed (for a total of 90 minutes). The patient was still symptomatic, so a separate order for an additional 1L NS bolus was made. The 2nd NS bolus was given from 1140-1255 (for a total of 75 minutes) on the same date of service.
The provider billed 96360 x1 unit and 96361x2 units. So I am assuming they added the total time between the two infusions which totaled 165 minutes and then broke that down by 60 minutes intervals to get 1 unit of 96360 billed and 60 minutes for the first unit of 96361 and 45 minutes for the 2nd unit of 96361.
My thoughts are that the claim should be billed with 1 unit of 96360 for the initial 90 minute NS infusion and 1 unit of 96361 for the subsequent 75 minutes NS infusion. My understanding is that for this specific scenario we should not be adding these two infusion times together since the infusions were truly not continuous (had separate orders for 2 different boluses and stopped between infusions- and not just for a bag change) and the two infusions should remain separate for purposes of calculating the times for each infusion since the 2nd infusion was subsequent to the initial infusion. Does this sound correct? Or regardless if the infusions administered are continuous with one another or not, would we just add up the total infusion time (as long as the infusion intervals are greater than 30 minutes)?
Clarification would be greatly appreciated. Thank you!