Wiki IV Coding-code for an urgent

[jackiemal]

I code for an urgent care center. We have a disagreement on how to code something as below:

Patient came in for kidney stone.

IV Saline lock @ 10:34am, Toradol IVP 30 mg @ 10:36am, Discontinue IV @ 12:42pm.

Would appreciate any help. We have looked at all of the search engine websites and we still argue over the correct way.

 

[OCD_coder]

96374 IVPush/Toradol
96361 x 2 (ran for at least 91 minutes)

If documentation states "keep vein open" you cannot bill the 96361 at all, it's not supported by medical necessity and it is inclusive to the 96374. I coded it as it did not state KVO.

You can only have one initial code (96374), therapeutic drugs trump hydration/saline run times so the 96360 turns into one of the 96361 to capture the time after the push to the 90th minute, once the 91st minute threshold is met you can then bill a 2nd hour of 96361 hydration.

 

[jackiemal]

Thank you, that was my thinking. We would just bill for the Toradol (J1885) then because the saline was included with the 96374, correct?

 

[ramirez505]

saline lock

Saline Lock is when there is no longer a need for continuous fluids, but there may be a need for further IV med/fluid administration. In my opinion an IV saline lock (no fluids running) was started to administer Toradal - the only charge should be initial IVP for the Toradal.

 

[mitchellde]

I agree with Ramirez, you can only bill hydration when you have a diagnosis of dehydration, or other similar medical necessity, when saline is started for the purpose of administering other drugs then you cannot bill the saline as hydration, and a lock says there is no continuous fluid running. The only charge I see is for the IVP.

 

[jackiemal]

I took another look at the chart. It says that the IV Saline 0.9% 1000 mL started at 10:35am via IV Bolus and discontinued at 12:42pm. The patient was in for Nausea, Diarrgea, Vomiting, and abdominal pain. If they gave the saline for the above would it have to say specifically for hydration?

 

[ramirez505]

hydration

Then the charge would be 96374 (1) 96361 (2) vomiting, diarrhea will cover the medical necessity. One more thing, was 12:42 the stop time for the IV fluids running or the time the IV was D/C'd? If 12:42 is the time fluids were stopped than you can get 2 hrs of IV hydration...if 12:42 is the time the IV was D/C'd than you don't have a stop time and you cannot count the hydration hrs. B )