Wiki IV therapy billing

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llmccann

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We recently starting billing for this service and I want to make sure I'm not missing any charges. For example, a patient receiving IV saline + medication. Is it correct just to bill 96365, for the 1st hour. Plus the J-code for the drug?

If it is pushed, do I use 96374 in addition, or instead of 96365? The providers are questioning an "iv start" charge also, is that the 96365?

Thanks for any help!:
 
llmccann said:
We recently starting billing for this service and I want to make sure I'm not missing any charges. For example, a patient receiving IV saline + medication. Is it correct just to bill 96365, for the 1st hour. Plus the J-code for the drug?

If it is pushed, do I use 96374 in addition, or instead of 96365? The providers are questioning an "iv start" charge also, is that the 96365?

Thanks for any help!:
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If the patient is receiving the medication being infused with saline, then you code for the 96365 if it is documented that it is 16 minutes or more up to the first hour. If you are just billing for saline for hydration and also giving a med IV push then it is 96374 for the med and 96361 for the saline if the saline is being given longer than 31 minutes. If you are charging a 96360, 96365 or 96374, you do NOT code for the IV start (36000) as it is already included in the initial procedure.
 
I know this is an older thread but I came across it trying to find the difference between the 36000 codes and the 96360 codes and the presentation you gave us the link to was AWESOME, thank you!
 
96365 or 96374

I am having difficulty in getting reimbursed for 96365 stating documentation does not support. The patient received Iron infused for exactly half an hour. Arn't I able to use this code as its description up to one hour? Not a push because the infusion is more than 15 minutes.

Please advise
 
ambonham

AAPC has an awesome webinar "Adminstering the Proper Coding of Infusions and Injections". I highly recommend it! There is an Injection & Infusion Table in it that clears up a lot of the confusion! After watching the webinar, we got with the pharmacist over billing. My understanding is when a pt. gets a hydration infusion, NS, D5W, electrolyte fluids, you bill 96360. Only one primary infusion code/enc. The pushes, ex. Zofran, are reported with + 96375. The 31 min. applies to 96360 , per CPT. The other state up to 1 hr., but this one specifically states 31min-1 hr. You may be getting denials on 96365 & 96374 because you are using 2 primary codes/infusion.
 
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