help hydration

perkins05

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patient came in for hydration...office billed the following

96360
96361
96367
96375
j1100
j1940
j2405
j2550
j7040
j0780


But scrubb is looking for an intial code for 96375 and 96367...but i thought we could only bill one intial which is 96360

Any help will be appreciated...
 
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You are missing an initial code. Plus, if you gave hydration with another infusion service, you can't use 96360. the ONLY time you use 96360 is ther are no other infusion or injection services as these services trump the 96360 initial hydration hour. Per CPT guidelines 96375 and 96367 state the following:

Use 96375 in conjunction with 96365, 96374, 96409 and 96409
Use 96367 in conjunction with 96365, 96374, 96409 and 96409
which are all initial codes
 

ollielooya

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"Perkins", just for the sake of continuing this thread and my own personal need to followup as the hydration/infusion codes perplex and enchant at the same time, could you post a scrubbed edition of the chart notes? CPT has attempted to clarify instructions in the 2012 edition yet this type of coding CAN be confusing. I wish it were straightforward, but it's not! (at least to me..) I think it would be beneficial to a lot of us if you would post a scrubbed note for follow-up! ---Suzanne E. Byrum CPC
 

hfrauham

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This would be my guess, but i feel like more info would help.

96360 x no, delete
96361 -2 units (if there are really 2 hours of infusion occuring, or two seperate hydrations where nothing else but fluid is being given for at least 31 minutes.) if anything else is being infused at the same time as the fluids listed as hydration, you may only charge for the fluids- as far as i have understood
96367 - this would be 96365- your initial infusion
96375
j1100
j1940
j2405
j2550
j7040
j0780

Make sure your units for the drug infusions are correct, i only see 2 infusion codes but 4 drugs being given.
 

ollielooya

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hfrauham has provided some invaluable insight and it seems this WOULD be the way to code the 96361 codes and delete the 96360 and to assign the 96365 as the initial. Can we take this one step farther? SOMEWHERE deep within the archives of this forum was a discussion concerning 96360 and given that it IS also an infusion (might) be considered as the "initial." However, by following the hierarcal rules in CPT for facility coding wouldn't that also be a good rule to follow in office based coding as well? In followup, basically what WOULD be the advantages or disadvantages to using the hierarchy in the physician's office? ---Suzanne E. Byrum CPC
 

lpetrova

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We looked at this issue a couple of years ago and after having discussed this with our oncologists we started billing the way suggested by Hfrauham. It was explained to the coders that while the initial reason for a pt's visit might be hydration, he/she is presenting with N&V. So, the management of these symptoms takes precedence over hydration. Therefore, therapeutic infusion is billed as an initial, followed by 96375 and then by 96361.

Sincerely -
 
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