infusion or hydration

tuffy1

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I am learning to code E/M and ER charges. I am having a problem knowing what is an infusion or just an IV or hydration. Is there a site or anything out there that can tell me what was given is an infusion or hydration? For example all I get is: D5 and the route is IV and total infusion is done in so much time. D5 does not tell me anything. Is there a book or web site or software that could help me to understand? Any suggestion please!!!!!!:eek:
 

srburk

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Hang in There

IV hydration and IV infusions are hard. If you will contact me via email I will get back to you when I get to work on Monday and give you a cheat sheet that has the guidelines. I have attended several webinars and spent the last two years reading everything I could get my hands on and the girls in my office wrote up our cheat sheet and i think it will help you. FYI. D5 is a type of fluid that they are hanging in a bag so what you are currently dealing with is a hydration. If they are talking about a medicine you will need to know whether or not they are administering it via IV Push or Piggyback to determine how to code the infusions and hydrations. PM me and I will get back to you. Suzette.
 

tuffy1

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I sent you a private message and gave you my e-mail address. Any help you can give me is very much appreciated. Thank you again srburk.
 
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can you please send me all the information you have regarding infusion and hydration guidlines. we are really confuse on how to code these and get proper reimbusersement. thanks in advance. rgzeeryp
 

ctodicheeney

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Infusion Confusion

IV hydration and IV infusions are hard. If you will contact me via email I will get back to you when I get to work on Monday and give you a cheat sheet that has the guidelines. I have attended several webinars and spent the last two years reading everything I could get my hands on and the girls in my office wrote up our cheat sheet and i think it will help you. FYI. D5 is a type of fluid that they are hanging in a bag so what you are currently dealing with is a hydration. If they are talking about a medicine you will need to know whether or not they are administering it via IV Push or Piggyback to determine how to code the infusions and hydrations. PM me and I will get back to you. Suzette.
Can you please include me in on that FRI cheatsheet I am having the same misunderstanding of that procedure and whether to add the J7030/J7050 and J7613 or A4216/A4217???....Help@ctodicheeney@yahoo.com:confused:
 
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mitchellde

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FYI D5 is a shorten term meaning D5W which is a 5% dextrose solution in water and is oftern given as a primary fluid for hydration but only to non diabetics, NS is a normal Saline solution also hung as a primary solution for hydration. To code IV hydration first of all you need a dx to support hydration, sometimes a primary fluid is hung just to KVO which is keep vein open , this is not for hydration purposes it is for convenience should they decide to push a drug or a secondary solution. Interqual criteria states to be therapeutic the rate must be at least 125cc per hour, otherwise it is for convenience. I always tell my students when coding for infusions, remeber the codes come as initial and subsequent types you can charge only one initial service if only one vein is accessed. So you may have initial therapeutic infusion then if the situation changes and they decide to hydrate the patient you would use subsequent hydration. If 2 veins are accessed then you will need a 59 modifier to charge for 2 inital services. I hope this helps to clear up some of it.
 

mlillard

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I would appreciate a copy of that cheat sheet also. Infusion and hydration are a very difficult coding problem.

Thanks,

Marilyn:)
 

Beth Neitz

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Ban

Does anyone have any written criteria as to the documentation guidelines required by nursing staff? Our ED Nursing staff refuses to document start and stop times and I am in need of billing guidelines.

I too would like a copy of your cheat sheet. baneitz@geisinger.edu
 

Eena

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Can this cheat sheet be posted to the Forum? If not, can I be added to the growing list who are requesting it? This has become a hot topic this week at our facility.
 

viswaas

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96360 payable icd list and modifier specific

Can you please include me in on that FRI cheatsheet I am having the same misunderstanding of that procedure and whether to add the J7030/J7050 and J7613 or A4216/A4217???....Help@ctodicheeney@yahoo.com:confused:
Hi,

I have seen the details you have specified in the forum but could you help me to get reimbursement for cpt 96360 iv fluid and is there any LCD and modifier Specific for this service, please help me to find a solution. My email ID: viswaas@yahoo.com

Viswaas
 
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IV infusion / Hydration / IVP is quite Simple once you get it down.

IVP (IV Push) is less than 15 mins
1st Drug 96374
Each addional sequential push of new drug) 96375
Each additional sequential push same drug (must be given over 30 mins after initial push) 96376

IV Hydration must run over 31 mins to 1hr 96360
Each additional hour of Hydration 96361 ( report for intervals of greater than 30 mins beyond 1st hour increment)
Hydration is considered Normal Saline, ect

IV Therapeutic Medicinal Drug
must run over 15 mins to 1 hour 96365
Each additional hour greater than 30 mins beyond 1st hour increment) 96366

96367 Additional Sequential Infusion up to 1 hour ( for a differant initial service admin through the same IV access)
Report only ONCE per sequential infusion of same infusate mix.

96368 Concurrent infusion - List only once per encounter (A concurrent infusion is one in which two drugs are simultaneously infused or multiple infusions are provided through the same intravenous line


I can break it down for you even farther if you would
like me too, i did Infusions for 3 yrs in the Emergancy room Setting.
 
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I found this today, its a copy of a webpage.

It may help some.

Copyright © 2008 by American Society of Clinical Oncology.
Concurrent Infusions
ASCO's Coding and Reimbursement Hotline continues to receive questions regarding concurrent infusions. In 2006, the current procedural terminology (CPT) Editorial Panel created a specific code, 90768, for concurrent infusions of nonchemotherapy drugs or substances. The questions and answers in this article are designed to provide additional information and clarification regarding the use of the concurrent drug administration code.

What is a concurrent infusion?

A concurrent infusion is one in which two drugs are simultaneously infused or multiple infusions are provided through the same intravenous line.

If a second drug is added to a bag for intravenous administration, can the administration of the second drug be reported?

No. More than one substance in a single bag is considered one infusate and one infusion. In this scenario, only one administration can be reported. However, the J-code for each substance or drug would be separately reportable.

If two drugs are infused simultaneously but hang in separate bags, is this considered a concurrent infusion?

Yes. If multiple drugs are hung separately but run simultaneously, the administration is considered to be concurrent. In this situation, you would report an initial or subsequent administration (depending on your identified primary service) for the first drug, and a concurrent administration for the second drug.

What if two drugs are mixed in the same bag and administered for only 15 minutes?

An infusion of 15 minutes or fewer is defined as a push, and the appropriate push code (initial or subsequent) should be reported. In this situation, the infusion would be reported as one push; however, each substance or drug would be separately reported.

Can more than one concurrent administration code be reported?

The CPT book provides clear guidance that concurrent infusion can be billed only once per patient encounter.

The Coding and Reimbursement Hotline receives many questions relating to the administration of leucovorin with an antineoplastic agent such as fluorouracil. Leucovorin is used in some chemotherapy regimens to enhance the antineoplastic effect; however, Medicare carriers, fiscal intermediaries, and/or Medicare Administrative Contractors have the discretion to determine whether the administration of leucovorin should be reported as a nonchemotherapy or chemotherapy administration.

http://jop.ascopubs.org/content/4/4/171.full
 
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I came across your infusion post response and was wondering if you may have an updated cheatsheet you could share, the post was from 2009 I believe :) or anybody?
It would be greatly appreciated!

Thanks in advance!!!
Sharon

sbeltowski@aol.com
 

alices

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infusions

if it isn't too late to ask and you aren't tired of sending to everyone can you please include me with a copy of it I would really appreciate it..thanks, alice
asalcido@sjgh.org thank you
 

codeds07

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IV cheat sheet

Hi Srburk
Tried to send you a private message but your inbox is full, could you please forward a copy of your IV cheat sheet to my e-mail? would truly appreciate it!

Thanks
donna s.
dsimba2002@comcast.net
 

DebbieChicoine

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Hi
I saw your post and would like to get a peek at that cheat sheet as well.
I would appreciate any help you can give.

I had a patient today that was seen at 8am for hydration and again at 8pm for hydration, can I bill two initial hydrations on the same day or should I bill for the second one a each add'l hydration ?
Someone had told me I could bill two initials with a modifier 76, is this accurate?

Again Thanks for any help you can give me
Debbieinnaples@aol.com
 

kumeena

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IV hydration and IV infusions are hard. If you will contact me via email I will get back to you when I get to work on Monday and give you a cheat sheet that has the guidelines. I have attended several webinars and spent the last two years reading everything I could get my hands on and the girls in my office wrote up our cheat sheet and i think it will help you. FYI. D5 is a type of fluid that they are hanging in a bag so what you are currently dealing with is a hydration. If they are talking about a medicine you will need to know whether or not they are administering it via IV Push or Piggyback to determine how to code the infusions and hydrations. PM me and I will get back to you. Suzette.
Yourmail box is full. i could not send you private message.

Please send me a copy of the cheat sheet and other resources.

meenakumarcoder@yahoo.com
 

dgribben

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cheat sheet

IV hydration and IV infusions are hard. If you will contact me via email I will get back to you when I get to work on Monday and give you a cheat sheet that has the guidelines. I have attended several webinars and spent the last two years reading everything I could get my hands on and the girls in my office wrote up our cheat sheet and i think it will help you. FYI. D5 is a type of fluid that they are hanging in a bag so what you are currently dealing with is a hydration. If they are talking about a medicine you will need to know whether or not they are administering it via IV Push or Piggyback to determine how to code the infusions and hydrations. PM me and I will get back to you. Suzette.
I would love to have a copy of the cheat sheet. Please e-mail it to me
dgribben@communityhoward.org
Thank you.
 
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Hello! Would it be possible to get a copy of your cheatsheet....it sounds great!

if so....slahood2@lghealth.org

Thanks!!!
Sue
 
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