Wiki IV Hydration question

[chaimz]

I'm looking to get certified as a medical coder.

W/in the CPT intro - under the time section - it gives an example: "If IV hydration (96360, 96361) is given from 11pm to 2am, 96360 would be reported once and 96361 twice."

If altogether the IV hydration is 3 hours - how is 96361 reported twice if the rest of the time after 96360 does not exceed 1h31m?

Please clarify this for me.

Thanks,

Chaim

 

[OCD_coder]

If 3 hours are given you have 96360 for the first 31-60 minutes, 30 min or less is not reportable for hydration. The 1st 96361 can be added when the 91st minute threshold is met. A second 96361 can be repoted when the sum total of 151 minutes threshold is met.

I am not sure where you are getting the 1h31min information from a 3h run as there isn't that limited time remaining from 60 minutes from the 96360, but 120m or 2h remain which is equal to 2 units of 96361. If only 91minutes of a hydration run were given, then only a single unit of 96361 and the primary 96360 code are reportable.

 

[chaimz]

If 3 hours are given you have 96360 for the first 31-60 minutes, 30 min or less is not reportable for hydration. The 1st 96361 can be added when the 91st minute threshold is met. A second 96361 can be repoted when the sum total of 121 minutes threshold is met.

I am not sure where you are getting the 1h31min information from a 3h run as there isn't that limited time remaining from 60 minutes from the 96360, but 120m or 2h which is equal to 2 units of 96361. If only 91 minutes of a hydration run were given, then only a single unit of 96361 and the primary 96360 code are reportable.

So let me see if I got this straight. the first 60m is for 96360. Then the next 31m (91st) is the first unit of 96361. then the third 31m (121th) is the second unit, leaving 59m left, nd because it is less than 1h increment, it cannot be reported?

 

[OCD_coder]

Almost there. I made an error and ran through my resources. Good catch!

You can select a CPT code with a unit of time when the half-way point is reached (Per CPT definition of a unit of Time), this is the 31st minute threshold for each hour since the Hydration codes are 1 hr increment codes. Remember the rule you cannot code hydration for 30 minutes or less. So each time the 31st minute mark is reached beyond the previous hour (= 91 min) you can add another unit of the 96361.

31-90 minutes = 96360
91-150 = 96360, 96361.
151- 210 = 96360, 96361 x 2.​

 

[chaimz]

Almost there. I made an error and ran through my resources. Good catch!

You can select a CPT code with a unit of time when the half-way point is reached (Per CPT definition of a unit of Time), this is the 31st minute threshold for each hour since the Hydration codes are 1 hr increment codes. Remember the rule you cannot code hydration for 30 minutes or less. So each time the 31st minute mark is reached beyond the previous hour (= 91 min) you can add another unit of the 96361.

31-90 minutes = 96360
91-150 = 96360, 96361.
151- 210 = 96360, 96361 x 2.​

So the latter numbers (90, 150, 210) are the end points before you are allowed to start another unit?

Based off this additional information, let me see if I understand by using example time periods:
88m = 96360,
97m = 96360, 96361
125 = 96360, 96361 x 2

 

[OCD_coder]

So the latter numbers (90, 150, 210) are the end points before you are allowed to start another unit?
Correct.

Yes - 88m = 96360,
Yes - 97m = 96360, 96361

No - 125 = 96360, 96361 x 2
Rationale: The time fell between 91-150 minutes and it would only count for 96360 for the first 60 minutes, and it reached the 91st minute for the add-on CPT code 96361. Because the time only reached into the 2nd 96361 by 5 minutes, which is not enough for a 2nd 96361.

Hydration Math:
125 divided by 60 = 2h (96360, 96361) 5m remaining minutes unbillable

The remaining minutes (5m) beyond the last hour (2h) needs to be a minimum of 31m for an additional unit of 96361.

 

[cjhalk@yahoo.com]

Hydration Math:
125 divided by 60 = 2h (96360, 96361) 5m remaining minutes unbillable


This is by far the simplest way I have ever seen it put.
I have never coded hydration like this; it?s always been pen and paper breaking down each hour and 31 minutes. This just got a great deal easier.
Thank you.

 

[chaimz]

So the latter numbers (90, 150, 210) are the end points before you are allowed to start another unit?
Correct.

Yes - 88m = 96360,
Yes - 97m = 96360, 96361

No - 125 = 96360, 96361 x 2
Rationale: The time fell between 91-150 minutes and it would only count for 96360 for the first 60 minutes, and it reached the 91st minute for the add-on CPT code 96361. Because the time only reached into the 2nd 96361 by 5 minutes, which is not enough for a 2nd 96361.

Hydration Math:
125 divided by 60 = 2h (96360, 96361) 5m remaining minutes unbillable

The remaining minutes (5m) beyond the last hour (2h) needs to be a minimum of 31m for an additional unit of 96361.

Ah, Gotchya. So the 96361 is the 31st minutes for the first hour (96360) and I would have to wait another hour to implement the next 31m for unit 2 (151st).

Thanks.