Additional vs. subsequent IV

[staceylh]

Patient has two ER visits, same date of service for cellulitis re-check and administration of Vanco. Patient receives two hours of infusion at each visit. Because we're combining the two visits for Medicare, do we code the initial hour 96365 with 3 additional hours 96366? OR, can we code the initial with 3 sequential as it's the same infusate? The ER record does not indicate whether or not they're using the same IV access site for the return visit.

[Mojo]

You can report 2 initial services when you have 2 separate IV sites or 2 separate encounters on the same DOS. Append modifier 59 to the second encounter initial infusion of Vanco. You will report the add on code 96366 twice to capture the second hour of each visit.