Wiki drug reaction

[jjazzmom]

How would you code this scenario:
Taxol started at 11:45
stopped at 12N for pt. having reaction. NS started KO.
12:45 Taxol restarted
2PM taxol ended.
I would code this as 96413, 96415 x 1

One of our nurses was talking about using"oberservation" codes when someone has a reaction - I have never heard or read anything about this. Would one be able to code for hydration even though the saline may be running at keep open? I usually take the total time the drug ran and subtract out the time it wasn't running and code on that. Any answers would be greatly appreciated.

 

[alannae]

The taxol is running for a total of 1 hr and 30 min, so you would only be able to bill 96413. You would need to have 1 more minute to add 96415. My nurses do this too. They document everything rounded to 5 minutes. It's a battle to get them to change that. You can only bill what is documented.

As for the hydration, you can't bill that unless it is medically necessary. If it is being done just to keep the line open/running, it is not medically necessary.