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96365 Infusion, initial

  1. #1
    Elizabeth City, NC / Chesapeake, VA
    Question 96365 Infusion, initial
    Medical Coding Books
    I am being told that we have several patients that come into our ED Observation Outpatient Procedural Unit to have vano (or another drug)infused 2x's per day, once at 6am and once at 6pm. It is billed under the sme encounter - bill #, as a matter of fact I am being told they leave the encounter open for the month if the patient is receiving longterm treatment. Would you bill the 96365 for the morning and another 96365 - 59 for the pm dose, since it is a seperate infusion or would you bill a 96365 for the am dose and a 96367 for the pm dose?

  2. Default infusion same day
    if they are using the same access site (IV site) then use the 96366.

  3. #3
    Elizabeth City, NC / Chesapeake, VA
    But the 96366 is for an additional hour of a drug being infused....I take that for a continual additional hour of an infusion not one that is started and stopped and then started later on?????

  4. #4
    I use initial for both visits since the pt actually leaves the facility and comes back in. We also have reoccuring pts that the acct stays open all month with multiple dos.

  5. #5
    Johnstown, Pennsylvania Chapter
    I agree with the above post. We do it the same way at our facility.

  6. #6
    Elizabeth City, NC / Chesapeake, VA
    Default 96365 - Infusions 2xs daily
    If you all are using the 96365 for both the AM and the PM infusion, are you modifying the PM and if so which modifier....59 or 76?

  7. #7
    when a pt is schedule for infusion on reaccuring accounts that requires the pt to come in twice in one day we charge a 96365 then a 96366 because they are receiving the same drug. We could have them sit at the facility until time for the next round but allow them to leave and come back.
    Now separate encounters are billed each initial.

    I would contact your compliance dept.
    Kristin N. Enderby, CPC

  8. Default ICD10 Codes
    What ICD10 codes can be used for 96365 besides hydration and Fatigue?

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