Wiki Coding for IV push of same substance for physician office

[burksmail]

I know this is a repeat question from 4/3/14 but I had no takers so I'll ask again

I'm looking for direction on coding for a physician office when the same drug is administered (after 30 minutes) via the same IV line. For example, Zofran is administered via a push and pushed again 35 minutes later. Code 96376 can be used for facilities only. Does the physician office have to use 96379 (unlisted service)? I'm sure I'm just overlooking something....Thanks for any help! Myra

 

[OCD_coder]

A push is billed as a push, you should not be adding the times together to bill an infusion code they are not defined as the same type of work by the CPT guidelines. This was described in the AAPC webinar on Infusions a few week ago. Only, IV infusion times of the same drug can be added together on the same DOS and reported.

You would use the 96375, sequential IVpush for each administration as long as an initial service is selected first that can be an infusion or a push depending on the type of drug administered. You cannot bill for a concurrent push into the same IV line of different drugs as there is no CPT code for this scenario.

The work of the administration is separately coded as it is considered separate procedures. The drug is added together as a single unit with the total quantity of the drug.

 

[roby0705]

Can you bill an IV push if they do not list the amount of time spent? I have 3 IVP but only 1 has total time spent for IVP (ie. Over 2 mins)

 

[ladondavis]

96375 is only reported for an additional push of a "different" substance. To report 96375 would be incorrect. There is currently no CPT code for additional pushes in the office setting due to they are not common in the that type of setting and no code has been created. My suggestion is to only report the initial push 96374 along with the correct units for the drug but you would not be allowed to report an additional push since 96376 would be the only correct code but has to be in a facility setting. Also FYI - time is a factor in reporting pushes due to any pushes of the same drug can NOT be reported if administered less than 30 mins apart. So if they had Zofran at 10:00, 10:15, 10:35, You can report the initial and the last only. Another suggestion is that if multiple pushes are given, since they are not reported in an office setting would be to give intramuscular for those meds that can be given either way. You can always bill 96372 multiple times.

 

[ladondavis]

Documentation for a push has to state "that it s a push (intravenous) OR the start and stop times. (which must be 15 mins or less). If it is an infusion, the start and stop times, volume, and rate must be documented.