LTibbetts
Guest
We are having yet another injection debate in the office and I was hoping to get feedback on this. I code for a small rural ER and I code the pro fees. The facility fees are done by a unit secretary in the ER and they do it by CDM, not CPT. No one up there is a coder and they don't even see CPT codes so we are having to clean up their messes constantly and hopefully, we are finally going to be able to do it ourselves soon.
The biggest problem is the hydration issue. They are constantly putting two initial codes on there, one for initial hydration and one for initial drug pushes. Now I realize that you are only allowed one initial per chart and we have told them that. But what about patients that come in with gastroenteritis or dehydration and get hydrated and then recieve drugs via IVP. Now, according to the heirarchy, as soon as they receive drugs, the hydration becomes incidental. Isn't that correct? But is that the case even when the patient comes in for dehydration? The patient also got Zofran, and fentanyl, which again, is related to the reason the patient is here in the first place...belly pain, N&V, dehydration, etc.
My supervisor wants to charge for both the infusion and the drug and have us put a -59 modifier on it because she says it's two different things. You just can't get around the initial code rule so I don't know how it could work. I don't agree and furthermore, I am hesitant to mess with that -59 code. I know how abused and overused it is. Can anyone help me with this?
The biggest problem is the hydration issue. They are constantly putting two initial codes on there, one for initial hydration and one for initial drug pushes. Now I realize that you are only allowed one initial per chart and we have told them that. But what about patients that come in with gastroenteritis or dehydration and get hydrated and then recieve drugs via IVP. Now, according to the heirarchy, as soon as they receive drugs, the hydration becomes incidental. Isn't that correct? But is that the case even when the patient comes in for dehydration? The patient also got Zofran, and fentanyl, which again, is related to the reason the patient is here in the first place...belly pain, N&V, dehydration, etc.
My supervisor wants to charge for both the infusion and the drug and have us put a -59 modifier on it because she says it's two different things. You just can't get around the initial code rule so I don't know how it could work. I don't agree and furthermore, I am hesitant to mess with that -59 code. I know how abused and overused it is. Can anyone help me with this?