Wiki Hydration with Interferon

[madsmacpc]

In our office we bill 96361 ( additional hydration) when we administer Interferon to our patients. It was recommended by NCI that we give hydration when providing Interferon to decrease side effects of the drug. Our problem is that the patient's DX code that we can provide is only the Cancer Dx as the patient is not in fact dehydrated. Of course the carriers are denying this as Inclusive. 96361 is being denied inclusive to 96413 ( initial Chemo therapy of Interferon) We have been adjusting this off for our patients but there seems to be a large volume. Is there an appropriate Dx code that we can apply to this that would be covered? ( a V code perhaps? )

Any help with this would be much appreciated!!

 

[OCD_coder]

If you are giving saline as part of the protocol to administer a drug, you cannot bill for hydration infusion separately. There is an LCD for hydration, but be careful about trying to "select" a Dx to justify billing your 96361 code.

If the patient were to come back later that day and get a separate IV due to side effects of the interferon given earlier, then you could bill a separate time block if it met the time requirements and add a mod-59.

Hope that helps.

 

[traci.susong@gmail.com]

We just participated in a Webinar hosted by HRAA and this type of scenario came up. It was communicated that because of the "toxicity" of the drugs and if it is documented accordingly that you don't need an additional diagnosis to support the hydration. However, if you are giving hydration just to "keep the line open" you can't charge.

When we give hydration with chemo, we only use the chemo code as the drug itself is toxic and the hydration aids in clearing the patient's system of the toxicity. We've never had any denials for hydration when giving during the chemo encounter.

 

[relong]

I agree with Traci. Certain regimes require hydration due to the level of toxicity and interferon is one of those regimens.