Wiki ED to OBS infusion charges

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Mathias, WV
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When a patient comes into the ED and has, say hydration start and stop time on day one,
Then gets transferred to OBS the next day and gets infusions start and stop time and or injections
My understanding is the hydration is coded as 96361 and the OBS coded as either 96365 or 96374 due to hierarchy
We are getting denials stating that an initial is needed on the first day along with the 96361.
However, we have an initial on the second day.
Do we code the hydration as an initial on day one for the ED
And then code the infusions as an initial on day two for the OBS also?

Thanks,
 
By what you documented here, in ED you said hydration start/stop time on day one. Was the transfer order for Observation or Admission? Doesn't matter just wondering. You state next day for infusions start and stop times. When the patient was discharged from ED all that coding stops and where the patient was discharged to begins. Your payer is correct, you need to code initial along with 96361 as this is obviously some type of round or other status.
 
By what you documented here, in ED you said hydration start/stop time on day one. Was the transfer order for Observation or Admission? Doesn't matter just wondering. You state next day for infusions start and stop times. When the patient was discharged from ED all that coding stops and where the patient was discharged to begins. Your payer is correct, you need to code initial along with 96361 as this is obviously some type of round or other status.
To understand, the Ed would get there initial charges then once transfered to Observation then OBS would get initial charges also?
 
Hi,

The hydration start and stop times ends in ED when patient transferred to OBS or ADM. In my facilities, we don't code hydration, pushes, etc. so I would check with your specific payer. Our facilities incorporate this as part of DRG grouping. So if the pt was in the ED for one day then that is what you code. If this was a Round, then check with payer about hydration. I don't think facility wise it is coded.

Hope this helps to clear any confusion.
 
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