Wiki When to unbundle E&M and IV hydration

[SBrant]

Is IV hydration considered 'separately identifiable' enough to bill with 99213-25 for dehydration due to gastroenteritis in a family practice? I have seen audits go badly when doctors consistantly unbundle E&M from IV, but I do not understand where to draw the line or how to explain it to the provider.

 

[OCD_coder]

Did the do any diagnostics (e.g. labs) to determine the diagnosis of dehydration and severity?

That could be an indication of a significantly separate E&M to support a 99213 beyond a brief evaluation to perform the hydration infusion.

 

[SBrant]

Thank you OCD. You have confirmed my thoughts on the issue.

There is no additional exam or test listed in the notes. The provider feels that the IV is outside of normal E&M processes so it should be billable for that reason. I will explain that the bundling rules state differently and without examination and test above and beyond the standard for the chief complaint, it cannot be unbundled.

Sometimes I just need to confirm with someone. I appreciate the response!