Wiki IV infusions with hydration

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plarabee

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I have a coder questioning my thought process so I decided to come to this forum to see what others think.

When a patient is in an Urgent Care center and receives an initial infusion of Zofran for 22 minutes, I would code this 96365. Infusion started at 10:00 a.m. and ended at 10:22 a.m. The patient then received IV hydration from 10:22 until 13:30. The coder wants to start billing the hydration time from 10:22 until 13:30. I say you cannot because you are charging for the first hour of infusion. She says it was only 22 minutes so why can't you start billing for the hydration when that is complete?

What does everyone else think?:confused:
 
Ah, the hydration and infusion coding trips up so many coders, and from my studies I'd advise you to take a peek at add-on code 96361. This is a subsequent service after a different initial service as explained in the CPT definition, so perhaps this might be something to consider? 96361x3. Perhaps others more experienced in this venue will comment or correct?
---Suzanne E. Byrum CPC
 
My apologies - I should have been more clear. What I meant was that for the first hour she wants to charge 96365 (for 22 minutes only) and the other 38 minutes she wants to charge the 99361. I say she cannot.....she can charge only the 96365 for the first hour and the hydration will not start until the second hour. Which of us is correct?
 
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