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Hydration on Non-Chemo days

  1. #1
    Default Hydration on Non-Chemo days
    Medical Coding Books
    We have denials and/or non payment on Non Chemo days when the patient comes in for Hydration. Patient has Nausea and pain so along with Hydration we also bill the admin for these other drugs such as Aloxi, Dexamathsone, Morphine ect.....the admin codes we are using are the 96367 and 96375. Any suggestions? In most cases the Insurance Co. will pay for the drugs but not that admins. Thanks

  2. #2
    Default hydration on non chemo days
    I don't have coding books handy, review the heir. rules, but you would code 96374 first for the push and then your drug eg: J2550, and then your 96361 times the approiate hours. I hopes this helps, I was misinterrpting this early in the year myself.

    Shaunta Brake,CPC

  3. #3
    Default
    Quote Originally Posted by BoeJerger View Post
    We have denials and/or non payment on Non Chemo days when the patient comes in for Hydration. Patient has Nausea and pain so along with Hydration we also bill the admin for these other drugs such as Aloxi, Dexamathsone, Morphine ect.....the admin codes we are using are the 96367 and 96375. Any suggestions? In most cases the Insurance Co. will pay for the drugs but not that admins. Thanks
    Hi;

    Both of these codes (96367 and 96375) are add on codes; you need an initial code.

    Another thing to look at is your diagnosis code for the hydration; are you using dehydration? Nausea should be fine as well; but see if your carrier has specific rules.

    Don't forget that your best source is the CPT book; the Infusion Coding Guidelines give you the hierarchy (so you know which code to use as primary) and lots of tips for coding.

    I hope this helps.

    Susan R, CPC, CPMA, CEMC

  4. Default
    and if your hydration time runs at the same time as your drugs, you can't charge the admin, only the actual Normal Saline, Dextrose, or whatever type of hydration being used.

    Amanda, CPC
    Urology coder

  5. #5
    Location
    Bettendorf, Iowa
    Posts
    133
    Default
    I agree with Susan R. You need a 1st hour non chemo admin then code the rest accordingly. You can only charge the hydration admin for the time its run on its own and make sure your dx is appropriate for hydration.
    Ruth Long CPC,CHONC
    relong@rccqc.com

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