Wiki CPT 96413 and 96360

[fmshero1]

I am new to coding infusions and hydration. I was using 96413 for the chemotherapy and hydration was added about half and hour before the infusion was complete which took half and hour. Should the hydration CPT code be 96360 with the 96413. I think this may be wrong since they are both initial service codes, so what code would I use for the hydration, would I still use 96360 with 59 modifier?

 

[thomas7331]

You're on the right track in thinking that you cannot bill two initial service codes (the only exception being if the two are at separate encounters or via a separate IV access site, in which case the modifier is supported). Assuming the hydration was run through the same access, you'd use the add-on code 96361 for that because the chemo is above it in the hierarchy and so the chemo gets the initial service code. 96361 requires a minimum of 31 minutes running independently of any other infusions in order to report one unit, so if it's exactly only a half-hour, it can't be reported. Also, hydration needs to be a medical necessary therapeutic service that is ordered by the physician - if it's only run for the purpose of supporting the chemo or to keep the vein open between infusions, then it's not reported. Hope this helps some!