Wiki IV started by MD

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mistypace

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Our MD started an IV himself on a few of our patients instead of the nurses. Is there a higher price or other CPT code used for the MD administering the IV instead of nurse? Normally our nurses, CMA's and MA's administer the IV's but there have been a few patients recently that the MD did it himself. Thanks in advance.
 
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I don't know why there would be an upcharge for an IV start regardless of who started it. If this is an office procedure and the office is charging, then I think it should be up to the office to pay the MD if s/he feels they really need to be paid for their act of kindness.
 
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fwnewbie said:
I don't know why there would be an upcharge for an IV start regardless of who started it. If this is an office procedure and the office is charging, then I think it should be up to the office to pay the MD if s/he feels they really need to be paid for their act of kindness.
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We use encoder pro to help with our coding. The description for 96365 states, "A physician or an assistant under direct physician supervision injects or infuses a therapeutic, prophylactic (preventive), or diagnostic medication other than chemotherapy or other highly complex drugs or biologic agents via intravenous route."
So to me that means whether the MD, nurse, MA or CMA administers the IV we charge the same code. I can't locate a different code for IV administration for MD specifically.
 
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I just have to say that I'm stunned that you have medical assistants starting IVs. Forbidden here in California - the only time a medical assistant is allowed to break the skin is for a subcutaneous or intramuscular injection.
 
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SharonCollachi said:
I just have to say that I'm stunned that you have medical assistants starting IVs. Forbidden here in California - the only time a medical assistant is allowed to break the skin is for a subcutaneous or intramuscular injection.
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I re-read that a few times before I posted and also thought that was odd and though there was no mention of what the IV infusion was, I'd be very concerned if this was a chemo/caustic infusion!
 
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fwnewbie said:
I re-read that a few times before I posted and also thought that was odd and though there was no mention of what the IV infusion was, I'd be very concerned if this was a chemo/caustic infusion!
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It was an IV with Gentamicin for cellulitis. The MD placed the heplock and started the infusion.
 
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mistypace said:
We use encoder pro to help with our coding. The description for 96365 states, "A physician or an assistant under direct physician supervision injects or infuses a therapeutic, prophylactic (preventive), or diagnostic medication other than chemotherapy or other highly complex drugs or biologic agents via intravenous route."
So to me that means whether the MD, nurse, MA or CMA administers the IV we charge the same code. I can't locate a different code for IV administration for MD specifically.
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There is no other code if the physician starts the IV; you will simply bill the appropriate initial administration code appropriate to the medication given and the route used. You do not get additional reimbursement because your office protocol is that the physician starts the IVs.

Re: the MA issue - I don't think anyone is disputing the interpretation of the code description. I think we're all concerned that this is seriously outside the scope of practice for a medical assistant in most states.
 
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