skelly
Contributor
Does anyone know if we need an order for Hydration services based on medical necessity? CPT codes 96360 and 96361. Any input would be greatly appreciated. Thanks.
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Medical Necessity for Hydration
- Thread starter skelly
- Start date
You should have an order for all services provided.
Hi,
As per Jan 2010 Coding Edge issue - we need to have the below pre-requisites for Infusions:
• An order and diagnosis for the service, which supports medical necessity;
• The name and dose (units/concentration) of drugs or substances provided;
• The route of administration (e.g., injection, push, infusion);
• The time the service was provided, including start and stop times for infusions and whether the infusion was initially started via ambulance; and
• The provider’s initials or signature.
Hope this helps you,
Thank You,
Purnima S, CPC
As per Jan 2010 Coding Edge issue - we need to have the below pre-requisites for Infusions:
• An order and diagnosis for the service, which supports medical necessity;
• The name and dose (units/concentration) of drugs or substances provided;
• The route of administration (e.g., injection, push, infusion);
• The time the service was provided, including start and stop times for infusions and whether the infusion was initially started via ambulance; and
• The provider’s initials or signature.
Hope this helps you,
Thank You,
Purnima S, CPC
mitchellde
True Blue
The answer is yes you need an order for medical necessity. In the ER sometimes an IV is ordered out of routin rather than clear medical necessity. This is done to establish a medication route in case the patient crashes. Interqual crtieria was always if the rate is less than 63 CC per hour then it was only a convienience and not therepeutic for the patient, meaning we could not charge for it. I have also worked in facilities where the standard of care was 125CC per hour was the minimum therapeutic rate. You also of course must have a diagnosis that supports rehydration as being medically necessary. If the IV was started for the purpose of administering IV push meds then you do not bill hydration at all, you code only for an Initial IV push.