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Can't bill for hydration???

  1. #1
    Default Can't bill for hydration???
    Medical Coding Books
    BSBC of MN just notified us we will not be able to bill for intravenous infusion, hydration (96360-96379). We are a multi-discipline family practice.

    I do understand the description 'These codes are not intended to be reported by the physician in the outpatient setting ' however, how can I bill for this service? Serious dehydration can occur with infants, sun stroke victims, elderly, severe flu cases, are we not supposed to treat these cases? or just do it for free?? Any suggestions??

    Thanks in advance!

  2. #2
    I bill hydration all the time and never have a problem . I know it doesnt help you out that much, but maybe this is an error on BXBS part.
    Good luck !!!

  3. #3
    Milwaukee WI
    Default Not billable by physician in faclity setting
    Actulally the guideline in CPT states: These codes are not intended to be reported by the physician in the facility setting. (2009 CPT Professional edition, page 435, last sentence in left hand column).

    If your practice is stand alone, it should still be reportable per CPT. If your practice is a hospital-based practice (as is our - all our "offices" are in hospital owned & operated clinic buildings), then you are in a facility setting, and therefore not able to use these codes.

    The reason physicians don't report the code in the facility setting is that the facility and not the physician actually purchases the supplies and usually hires the nursing staff who perform the procedure.

    If you are not in a hospital-based facility, then you should contact BCBS for clarification ... do they prefer to pay you for handling these cases in the office, or do they prefer that you send patients to the ER for this medically necessary treatment?

    F Tessa Bartels, CPC, CEMC

  4. #4
    Wow. Impressive. I appreciate all my smart friends! Thank you, Tessa.


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