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Add-on codes

  1. Default Add-on codes
    Medical Coding Books
    some interpret the add on codes to be billed with the code for primary procedure which to me is the code in the same category. for an example, coding 96361 must be billed with 96360? thanks so much

  2. Default
    96361 has to be billed with a primary code... the primary code can also be 96374 or 96365. It does not have to be the 96360.

  3. #3
    Default
    I have to disagree with you eadun.

    96361 has to be billed with 96360 or it is not billable, this is hydration by time.

    96374 is a push, not an infusion, and 96365 has its own add on codes.

    After each add on code it clearly tells you what codes it must be attached to. I see the note about using it with those codes but the 96360 still has to be there to attach it too.

    Laura, CPC, CPMA, CEMC
    Last edited by LLovett; 02-10-2010 at 02:30 PM.

  4. Default
    Quote Originally Posted by katmryn78 View Post
    I have to disagree with you eadun.

    96361 has to be billed with 96360 or it is not billable, this is hydration by time.

    96374 is a push, not an infusion, and 96365 has its own add on codes.

    After each add on code it clearly tells you what codes it must be attached to. I see the note about using it with those codes but the 96360 still has to be there to attach it too.

    Laura, CPC, CPMA, CEMC
    Laura,

    I have been coding infusions, injections and hydrations for many, many years in the ED. You CANNOT have a 96360 and a 96374 nor can you have a 96360 and a 96365. The codes 96360, 96365 and 96374 are all PRIMARY codes. However, if you do nothing but hydration for say 2 hours, of course it will be 96360 and 96361. However, if you do an infusion more than 15 minutes with hydration of an hour it is 96365 and 96361. Again, if you do an infusion greater than 15 minutes, a push and hydration for an hour it is... 96365, 96375 (add on code) and 96361. I can get you proper documentation when I return home this evening if you wish. I do not have any of my books with me.

  5. #5
    Default
    Eadun is correct. 96361 can be used as an add-on to codes 96360, 96365, 96374, 96409, or 96413. It says so right in the CPC book.
    Walker Bachman, CPC, CPPM

  6. #6
    Default
    I'm not a facility coder so my answer is based on the professional side and my experiences with that.

    Laura, CPC, CPMA, CEMC

  7. Default
    Laura,

    It would be the same on the pro side if done in a doctor's office too. I was totally confused in the beginning too. I kept saying that if 96361 is an add on code it HAD to be billed with the 96360. Unfortunately, that is not the case. It took me a bit to actually "get" it, but I finally did. I still think it is rather confusing if you really don't know. I think the guidelines are very vague on it.

  8. Default Iv push
    Is there any condition when we can bill 96374 twice? Please advice

  9. Default
    eadun2000 please I would like to see some of your documentation on this. I completely agree with you that you cannot have two primary codes on a claim, however, Medicare Eff 4/29/13 started denying all our claims that have the 96361 with 96365 stating we need the 96360. I advised them that we previously sent it in that way and It was denied because it was two prime codes. Since then, weve been using the 96361 for many years, now all of a sudden were getting these denials.

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