RARjuni:
You should review the section of the CPT manual prior to the hydration codes. I think you may misunderstand the 'hierarchy'.
5. When reported by the physician, report the "initial" code that best describes the primary reason for the encounter regardless of the order in which the infusion or injections are administered.
6. When reported by the facility, the "initial" code should be reported in the order of chemotherapy services, followed by therapeutic/prophylactic/diagnostic service, followed by hydration services, followed by infusion, followed by pushes, and finally injections.
The first step in determining which 'initial' code to bill would be to separate the types of drugs infused/pushed into chemo and non-chemo. If chemo drugs are billed, then chemo is more than likely the reason for the encounter and the initial code should be a chemo admin code (96413 or 96409 depending on infusion time).
I bill for a physician group and have never come across a case where the patient is getting chemo drugs but the chemo is not the primary reason for the encounter. Does anyone have an example of when this might occur?