Wiki IV Infusion - I am coding for a treatment

[LINDAACOSTA]

I am coding for a treatment patient who comes in everyday for an IV Infusion. Registered as a recurring patient; therefore, only one initial can be on the claim unless different vascular sites were used. In this case senario The nurse starts a new IV everytime the patients comes in for a treament within that encounter. I used 96365, but I am stuck on coding the additional infusions for the days the patients came in? Help?

 

[jackson7591]

Reference

http://medical-coding-carers.blogspot.com/2010/05/iv-infusions-and-hydration-coding.html

If there is appropriate documentation, first visit may have been an e/m if office visit and MDM documenting need for IV hydration, then 96365.

Again, based on documentation, you may be able to code for an e/m to evaluate medical necessity for hydration, each visit and hydration code. If a povider has scheduled a hydration tx schedule over several visits, may be able to code 99211 and 96365, so long as incident to conditions are present and documented.

Are you under the impression you cannot code 99365 for multiple visits?

 

[mitchellde]

I am coding for a treatment patient who comes in everyday for an IV Infusion. Registered as a recurring patient; therefore, only one initial can be on the claim unless different vascular sites were used. In this case senario The nurse starts a new IV everytime the patients comes in for a treament within that encounter. I used 96365, but I am stuck on coding the additional infusions for the days the patients came in? Help?

I am a little confused by your question as well. the initial infusion codes are for each encounter not for the life time. Also you cannot use 96360 just because you started an IV, you can charge hydration only for therapeutic hydration and it must run for a minimum of 31 minutes. If you started an IV for therapeutic reasons then you use a therapeutic IV code for the type of drug infused such as chemo. IF you started the IV to give pushes then you code only the push codes. I you can clarify what drug you were giving and how it was infused I can be of more assistance.

 

[LINDAACOSTA]

http://medical-coding-carers.blogspot.com/2010/05/iv-infusions-and-hydration-coding.html

If there is appropriate documentation, first visit may have been an e/m if office visit and MDM documenting need for IV hydration, then 96365.

Again, based on documentation, you may be able to code for an e/m to evaluate medical necessity for hydration, each visit and hydration code. If a povider has scheduled a hydration tx schedule over several visits, may be able to code 99211 and 96365, so long as incident to conditions are present and documented.

Are you under the impression you cannot code 99365 for multiple visits?

Yes, because it's for the same encounter and you can only have one initial.
Thanks

 

[LINDAACOSTA]

I am a little confused by your question as well. the initial infusion codes are for each encounter not for the life time. Also you cannot use 96365 just because you started an IV, you can charge hydration only for therapeutic hydration and it must run for a minimum of 31 minutes. If you started an IV for therapeutic reasons then you use a therapeutic IV code for the type of drug infused such as chemo. IF you started the IV to give pushes then you code only the push codes. I you can clarify what drug you were giving and how it was infused I can be of more assistance.

It's an IVPB (Rocephin) 96360 and for each day a new IV is started. The patient was registered as a recurring patient; therefore, one encounter, one account number. My understanding is you can only have one initial per encounter.
Thank you for your assistance.

 

[mitchellde]

Ok so each day is a new encounter if this is outpatient. However you cannot charge for hydration (96360) just to start the line for the convenience of administering the IVPB, you must have medical necessity for the hydration so what you have on each encounter is initial IVPB as an initial infusion for 96365, as long as it exceeds 15 minutes. If the Rocephin is not infused over at least 15 minutes then you must bill it as an IV push initial 96374. SInce it is a scheduled encounter for the drug there can be no office visit charged only the admin code.