Wiki 96374 versus 96375

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adecker

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Hi, Question

There can only be one initial code billed on the same day correct here is what codes are being billed

non chemo
pt received 3 ivp, 1 ivmb, 1 hr of hydration dx 346.90, Done in location 20
96365 x1 time medication infused 1802-1850
96361 x1
96374 x1
96375 x2
94760
99215-25

Please advise thanks :D
 
adecker said:
Hi, Question

There can only be one initial code billed on the same day correct here is what codes are being billed

non chemo
pt received 3 ivp, 1 ivmb, 1 hr of hydration dx 346.90, Done in location 20
96365 x1 time medication infused 1802-1850
96361 x1
96374 x1
96375 x2
94760
99215-25

Please advise thanks :D
Click to expand...

it should be 96365; 96375 x3; 96361
 
It would really help to have more information. The reason for the visit, and the reason for the medications. You can have only one initial but it is hard to tell from this which one should be initial.
 
Not necessarily. If you are coding for the physician the initial code goes to the code for the reason for the encounter. Per CPT:
According to CPT for facility coding chemotherapy services are primary to theraputic, prophylactic and diagnostic services which are primary to hydration services. Infusions are primary to pushes, which are primary to injections. Hydration codes are facility reporting only. For physician reporting initial code that best describes the primary reason for the encounter should be reported irrespective of the order in which the infusions or injections occur. So the documentation will determine which gets the inital code for the physician.
 
96374 versus 96365

Good Morning, this patient was seen in Urgent Care for gastritis and abdominal pain. I am billing for the physicians not facility and this is NOT for Chemo infusions.. I just wanted to make sure that only 1 initial code is allowed and I was curious as I coded as

pt had 3 doses of morphine ivp and minibag of zantac and iv fluids in UC setting (20 pos) Thanks

96365 x1 IV minibag initial (zantac)
96375 x1 new drug IVP addtl (morphine 4mg first push)
96376 x2 same drug IVP addtl (morphine same drug pushed addtl 2 times)
96361 x1 IV hydration 1550-1655
99204-25
 
96376 is facility reporting only, not for physicians. 96375 is for the additional but can be reported only one time for the same drug. so it looks like you would have
96365 x1
96775 x1
96561 x1
99204 - 25
 
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