Wiki Infusion/hydration question

[jkunsag]

Good afternoon,

I would greatly appreciate any advice on the following topic:

In the oncology department some patients receive hydration as well as their medication either due to dehydration, or due to the renal toxicity of the chemo. Hydration is given per the doctor's order. Previously our billers were consulted and advised that they should credit the hydration hours from the infusion. Now we have different opinions, and we are trying to clarify this issue.

In short the question is:
When a patient is receiving an infusion of medication and also IVF for hydration is the time of the hydration deducted from the infusion hours?

Thank you in advance,
Judith

 

[maryyromeo@hotmail.com]

If the physician has ordered Hydration due to dehydration and if given pre or post; both and it is more than 31 minutes you would use 96361. I am not sure why you would deduct infusion time.

Here is and Example: For this patient I would code 96375 for Decadron, 96361 for the Hydration and 96413 for Toposar.

Dexamethasone (DECADRON) 12 mg in Sodium chloride 0.9 % 50 mL infusion
Total time: 7 Minutes
Associated diagnoses:
Nausea, Prophylactic

Sodium chloride 0.9 % 500 mL infusion
Total time: 32 Minutes
Associated diagnoses:
Dehydration
*
Etoposide (TOPOSAR) 246 mg in Sodium chloride 0.9 % 500 mL infusion
Total time: 1 Hour 2 Minutes
Associated diagnoses:
Nodular sclerosis Hodgkin lymphoma of intrathoracic lymph nodes (HCC) [1469305]

*
I hope this helps. If you have any further questions let me know.

 

[jrs7117]

infusion hydration

This is an example of what I do...

CHemo drug given from 8:00am - 9:00 am (60 min) 96413
Hydration infusion given from 8:30am - 10:20 am (110 min. - 30 min of concurrent run = 80min) 96361

I bill the 96413 from the chemo infusion and then deduct the 30 min. from the hydration that it ran concurrent with the chemo drug.
I would then code the hydration 96361

Julie Williams

 

[OncologyOKC]

You have to make sure that the saline being provided is not considered part of the oncology infusion. The fluid used to administer the drug (s) is incidental hydration and is not separately payable. It is common for the infusions to start with saline while waiting for the drug to be mixed, then continued for a period of time after the actual drug was infused to clear the line as well as maintain it pending administration of any other necessary drug. In this case it is not hydration therapy and not billable. You also have to make sure you are meeting the minimum volume requirement (if applicable) for hydration therapy. My local Medicare carrier states that anything less than 500ml is not reasonable and necessary.


Hope this helps.