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What is the correct CPT codes to bill out IV hydration with Zofran push on pregnant patient with hyperemesis? We have been billing 96374, J2405 and 96361 if over 1 hour. Is this correct or should we also be including 96360?
That coding is correct, assuming there is a separate physician order for both the drug and the hydration. As I understand it, 96361 may be billed if the time of the hydration (excluding any time given for the push) exceeds 30 minutes as that it the half-way mark for the additional hour code, so you do not necessary have to be over 1 hour.
Agree with Thomas. You would not use 96360 unless you were only doing hydration. It's been a few years since we did infusions, but my understanding is there is one "initial" labeled code per infusion site. You use the "initial" on the primary reason for the infusion, not necessarily which one was done first chronologically.
Would this apply to the following scenario as well? Pregnant patient is dehydrated due to excessive vomiting. Seen for in office hydration.
Lactated Ringers (LR) is being administered because the patient is dehydrated. 1000 mLs and is administered over 1 hour total
IVPB Zofran (small bags (50cc) are for administering the medication) is also administered as for 15minutes at the start of the infusion.
after that is completed the patient then receives the hydration with the LR only for the remainder of the 42 minutes.
Iv placed 3:38
LR start time 3:49
3:52 to 4:07 Zofran IVPB is started for 15 minutes
4:07 to end time 4:49 therapeutic hydration only – 42 minutes
IV removed at 4:51
Would this be correctly billed as
96374 - J2405
96361 ??
The hydration is the primary reason but they are also administering the medication to treat the symptoms causing the hydration .. so do i follow the coding heiarchy or the reason for infusion rule??