AAPC - credentialing the business side of medicine

cpicerno · #1 07-29-2011, 11:44 AM

I am having a problem with coding Dextrose when used in a hydration for a patient. I am given IV NS 1000 ml Bolus IV D50 19g mixed in IV bag, but besides the 96360 and J7030 I am not sure on how to code for the dextrose for this patient. I have looked at the HCPCS book and it has the J7042 which is for Dextrose 5% / normal saline solution, but I am not sure which code to use. Then what happens when we give a different dose of dextrose such as 9gms, 12gms, 25gms?? Can anyone help me out??? Thanks!!

jackson7591 · #2 07-29-2011, 12:17 PM

http://www.cms.gov/manuals/downloads/clm104c12.pdf

section 30.5 subsection E may address your questions?

cpicerno · #3 07-29-2011, 01:27 PM

I don't see how this relates to my question... Sorry.... I do see where it does talk about hydration but I need more advice on how to bill for this drug not just hydrations... Thanks for your input though...

jackson7591 · #4 07-29-2011, 02:44 PM

per same source

section B states hydration codes "are not used to report infusion of drugs or other substances." Once the D50 was added to the IV bag, hydration codes would not seem appropriate.

section C would be apprporiate "Therapeutic, prophylactic and diagnostic injections and infusions (excluding chemotherapy)." 96365

http://www.asco.org/ASCO/Downloads/C...t%20091708.pdf

and then code for the medication given.

Section E would refer to a situation in which an hydration was started and subsequently additional medications were administered.

Mojo · #5 07-29-2011, 07:49 PM

I agree with Jackson that the D50 added to IVF is a therapeutic infusion.

Was the D50 added to the liter of NS or into a separate partial-fill bag of 50-100 ml or other carrier solution? Code as an infusion if greater than 15 minutes. The D50 is an unclassified drug J3490. Modifier JW is appended for the drug waste on a separate line when you do not use all of the drug.

cpicerno · #6 08-02-2011, 01:21 PM

Hi Mojo... The D50 was mixed in the IV bag....

Mojo · #7 08-02-2011, 05:51 PM

Quote:

Originally Posted by cpicerno

Hi Mojo... The D50 was mixed in the IV bag....

I was wondering if you had a therapeutic infusion of the D50 in a separate IV bag in addition to hydration with the liter of NS.

If the D50 was added to the NS, it was a therapeutic infusion.

Don't use the J7042 for this scenario of D50 added to normal saline. J7042 is a pre-packaged solution without additives.

cpicerno · #8 08-03-2011, 09:24 AM

No we only hang one bag and put the D50 into the NS. What happens if it is under 15 minutes for the infusion??

Mojo · #9 08-03-2011, 12:26 PM

An intravenous push is an infusion of 15 minutes or less. This definition is listed before the hydration codes in the CPT manual.

cpicerno · #10 08-03-2011, 12:34 PM

Quote:

Originally Posted by Mojo

I agree with Jackson that the D50 added to IVF is a therapeutic infusion.

Was the D50 added to the liter of NS or into a separate partial-fill bag of 50-100 ml or other carrier solution? Code as an infusion if greater than 15 minutes. The D50 is an unclassified drug J3490. Modifier JW is appended for the drug waste on a separate line when you do not use all of the drug.

In here you stated to code as an infusion if greater than 15 minutes... does an infusion always have to be greater than 15 minutes?? What do you code it as if it is less than 15 minutes??