Wiki Hydration with Chemo

[aschaeve]

1. Can you bill hydration (J7050 or J7060) at the same time as chemo?
2. Is hydration only billable before or after chemo?
3. When would you be able to bill separately for an E&M with chemo? If discussing side effects, looking at labs etc..
4. Would you consider billing separately for an E&M if the provider is just looking at labs and they are normal and tell the nurse to proceed with Chemo?

Thanks,

Alicia, CPC

 

[tkermode]

1. Can you bill hydration (J7050 or J7060) at the same time as chemo?
2. Is hydration only billable before or after chemo?
3. When would you be able to bill separately for an E&M with chemo? If discussing side effects, looking at labs etc..
4. Would you consider billing separately for an E&M if the provider is just looking at labs and they are normal and tell the nurse to proceed with Chemo?

1. Yes, you can bill for hydration on the same date of service as a chemo infusion, if it is medically necessary. For CMS and payers who follow CMS guidelines the J-code is bundled into the 96360/96361.
2. Hydration is NEVER billable conccurently; you can never bill for hydration time that overlaps with any other infusion or injection service.
3. Almost always, I will see if I can attach a reference from ASCO regarding this.
4. Yes.

CMS guidelines on hydration (you might need to look for the LCD/article from your MAC):

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=54635&ver=30&=

ASCO recommendations on E/M on the same date as chemo/infusion procedure, attached.