Wiki Need help Ivpb infusion coding

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GAcoder

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I'm studying up on iv infusion coding but still am struggling to get it right
What codes would be for this situation in urgent care:

23:00 new bag ivpb zosyn
23:32 new bag sodium chloride
23:45 end zosyn
23:47 new bag ivpb vancomycin
01:56 end vancomycin
06:21 new bag zosyn ivpb
11:56 new bag zosyn ivpb
13:45 end sodium chloride
 
I would code like this:

96365 (zosyn, 45 min)
96367 (vancomycin, 1st hour)
96366 (vancomycin, Add' hour)
96376 x 2 (zosyn, ivpb same substance)
96361 x 14 (sodium chloride, 14 hours)
 
If the sodium hydration (96361) was to KVO (keep vein open) this code cannot be billed, this is a Medicare rule. Since there is no medical necessity shared, hold off on that code.
 
It is assumed KVO unless there is medical necessity to support the 14 hrs of hydration. Medicare states saline ran to help administrate drugs is inclusive to the infusion codes and not billable separately.

Is the patient severely dehydrated? What does the documentation state that would support the need that much hydration besides "standard protocol"?
 
IVPB infusion coding

I would code it exactly as BustJenn has written in her response to your query. However, if the hydration therapy is not KVO and there is medical necessity for the sodium chloride, you will need to deduct the hrs the vancomycin and zosyn ran from your total hydration hrs. B )
 
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