IV hydration with IVP coding

lisafer360

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We are starting IV Hydration service at our practice...….If the patient comes in for IV hydration without an IVP the coding seems straight forward. I am confused about if there is an IVP midway. Example:
Normal Saline
start time 0810
stop time 1000

Zofran - IVP
start time 0900
stop time 0901

I am confused about a couple of things.

1. Does the IVP become primary due to the heirarchy?
2. Do I subtract the IVP time from the total time of the hydration?
3. How would this scenario be coded?
4. I am seeing where an IVP should be counted as 15 minutes. Is that only if the actual time isn't documented? In this case it was a minute.

I have pulled my MAC guidelines and some other info but I am still confused.....
 

rsinoben

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What is the main reason they are there?

If it is for nausea then it would be 96374 X1, J2405 X (you didn't give the dose)
J7030 (if 1000 mg) X1 96361X2

If they are there for hydration then

J7030 X? 96360 X1, 96361 X1
96375 X1 J2405 X?

Or if you want to follow billing guidelines versus coding (some insurances will require it)

then Therapeutic codes are always hierarchal over hydration so it would be 96374 X1, 96361 X2 plus the J2405 and J7030
 

lisafer360

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Thank you - mostly we will be referring our own physicians group of patients to our UCC for hydration. Typically for pregnancy related nausea/dehydration.


The intent will always be IV hydration but on occasion there will be a drug IVP as well and I want to be sure that I deal with the IVP scenario going forward correctly. It appears from your answer below that the hierarchical grid depends on the intent or purpose of the hydration (meaning IV hydration was ordered and also happens to have an IVP at the same time, vs IV hydration that is required as part of a infusion)……

Does the amount of time reported for the IVP affect the amount of time billed for the hydration?

Does my information change any of your answer?
 
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I am not an expert on infusion services but I don't believe that concurrent hydration is separately reported. I note that the times of infusion overlap so these were not sequential services. Recommend reviewing CPT instructions for hydration and for concurrent infusions. Cindy
 
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