Wiki Hydration billing with other infusions

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williamsonjk

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Can hydration be billed if it is paused to give another infusion and then restarted again? For example, hydration has been given for 45 minutes. The bag is then paused and Rocephin is given for 30 minutes and then hydration is started again to run for another hour. Everything I have read states hydration has to be before or after an infusion. Any advice on this would be much appreciated.
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I would ask why the hydration is being given. I have an article from Noridian which states, " It is important to distinguish the medical necessity of hydration from the use of fluid administration intended only to initiate flow or to keep the vein open. When the sole purpose of the IV fluid administration is to establish and /or maintain vascular access or patency of the IV lien, the service is neither diagnostic or therapeutic and must not be separately reported. To qualify as medically necessary hydration, the rate of infusion should support performance of this service for rapid replenishment. Maintenance IV therapy replaces normal sensible and insensible fluid losses, not losses associated with pathological conditions.
 
if the hydration is being given to help deliver the more complex drug, then it would not be captured. But based on individual organizational policy, some places capture the hydration if its over a certain amount of ml, or over a certain time. best to query.
 
In my experience, if the hydration is part of the treatment regimen and specifically in the order to be given pre and/or post drug infusion, it is billable. We have one medication - I believe it's Cisplatin - that causes significant kidney toxicity when given so hydration is always part of the regimen. Pre & post drug infusion for a defined period of time. We don't have issues getting paid for it. If hydration is given strictly to keep the IV open regardless of other meds given, it's not billable. Check how the regimen is written and, as stated by the other posters, why the hydration is ordered. What is your company's policy regarding hydration administration? I did a quick search and didn't see anything indication hydration was recommended or required with Rocephin administration so I would look for some other reason, such as nausea, vomiting, dehydration, diarrhea, etc for the hydration.
 
If I might tag a question onto this infusion discussion . . .
The situation of hydration given for a toxic drug (like Cisplatin) occurs frequently where I work. My problem is the diagnostic code to use / how the provider should document the need for hydration. Any suggestions?
 
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