can some help with infusion question

tonplair@gmail.com

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I am having problem with getting 96375 paid with patient just getting fluids and kytril and dexamaethsone. How would you code this: we code it as 96360, 96375, and 96361 the dexamaethsone and kytril was giving for 15 minute and the Sodium was giving for 2 hours and 15 minute and the primary reason for coming in was for the fluid. Can you tell me how this should have been coded or if it was coded right. We also put 59 modifiers on 96375 and 96361. This was submitted to Medicare.
 

hfrauham

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You would code the drug infusions first, then the fluids, if that is all that was being done and nothing was mixed in the bag. If you have a j-code for the sodium, then you would actually charge that as a drug infusion as well.

so- just fluids and nothing added to the bag i would code 96374/96361x2 plus drugs and fluid that was infused for hydration
if sodium was added to the saline solution i would code 96365,96366,96375 plus drugs given



hopefully that made sense!
 

skeeley

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Make sure to remember that 96374 is for a 15 min or less infusion. Correct to code the drug infusion first...the 96365 is your primary and the pushes would be 96375.
We spent a whole day with Marty Sloop going over our infusion scenarios and making sure we coded correctly. She told us that if meds are pushed the primary is 96365, then fluids 96361, and then pushes 96375. If no meds...just fluids we were told to use 96360 and 96361 for additional hours.
 

abc1099

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Was there documentation as to why the decadron and kytril were given? We do not code those as primary unless the nurse documents the reason for giving anti-emetics, then we add codes for those reasons and make the hydration secondary.

Are you adding additional diagnosis codes when you bill them as primary? Thanks for your input.
 

mitchellde

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In the "CPT Changes for 2012" the AMA makes a clarification for infusions. The hierarchy as stated in the book is for facility reporting only. Physicians are to code first the infusion code that matches the reason for the infusion. So if the fluids were started for the purpose of hydration then the 96360 code goes first as long as it infused a full 31 minutes prior to any push. then the 96361 and then the push.
 
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