Wiki IV push with IV hydration

[Lisa Bledsoe]

I need a little help please...for the guidelines under Therapeutic, prophylactic, and diagnostic injections and infusions...it states "when fluids are used to administer the drug, the administration of the fluid is considered incidental hydration and is not separately reportable"... but what if the patient is being hydrated (first) and also given one or two IV push meds during the hydration (say phenergan and demerol). Would you code 96360, 96361 and 96375 x2? Or does the IV push become the primary? Would you be able to code the hydration at all? I am chasing my tail on this one. I appreciate all responses (I will be on a mini-vacation 6/17-6/22 so I'll be oh-so-happy to read the forum on 6/23).
Thanks to all!!

 

[LTibbetts]

As soon as the patient receives any drugs via IV pushes, then they become the primary charges as they "trump" over hydration services. You can code the hydration, but only if it is over the 1st hour time limit (this can be only 5 minutes, but over one hour is over one hour whether it be 2 minutes or 45 minutes). You would code the 96374, 96375, and then the 96361 if the hydration went over an hour. There is a hierarchy for injections and infusions and there is a post somewhere in this forum that relates it the the King, Queen, and Jacks in a deck of cards. The hierarchy is:
medication infusions (King)
IV Pushes (Queen)
Hydration (Jack)
Injections (SQ)

Chemotherapy also has a hierarchy that is much the same but maybe a little more involved. The hierarchy is mentioned in your CPT coding book right before these codes so just try to go over it again and after a while, it will start to make more and more sense to you. Hang in there! Aside from E&M coding, these were the most difficult for me to understand in the beginning.

 

[Lisa Bledsoe]

Thanks Leslie.