Emergency department infusion facility coding

Before going into the topic will see some medical terms of infusion coding.

IV Bolus – A specific unit or volume to be Administered

IV Hydration – The administration of solution (hydration) consisting of a pre-packaged fluid and/or electrolytes.

 

IV Infusion – Introduction of fluid (with or without a medication) intravenously. An IV pump or controller may be utilized to regulate the rate of administration

IV Injection – Forcing a liquid (or medication) into a vein, usually using a syringe.

IV Piggyback (IVPB) (IVPG) or IV Secondary Set (IVSS)  intravenous infusion– This refers to a medication solution (a secondary set) attached to an existing IV line and “piggybacked” via IV line into the vein.

Intravenous (IV) – Within a vein or veins.

 

IV Push (IVP) – The administration of a medication by push or force into a vein.

Hierarchy of coding injections for facility Ed

Infusion

push

Hydration

Intramuscular

Inhalation

Some guidelines to follow infusion coding

1.Need to check start and stop time ,iv line or route ,status whether it is complete or discontinued.

2.Minimum time to code initial infusion is 16 mins Or greater .Less than mins code as IV push.

3.For coding subsequent infusion min of 31 min is required.

4.Initial infusion is primary reason for encounter

5.Sequential infusion is infusion of new substance following primary service.

6.Concurrent infusion is infused at the same time as another substance.

Infusion

96365  Initial infusion up to 1 hr

96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)

96367 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); additional sequential infusion of a new drug/substance, up to 1 hour (List separately in addition to code for primary procedure)

96368 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); concurrent infusion (List separately in addition to code for primary procedure).

Examples:

Drug A

10.00-12.00-96365,96366*1

Drug B

12.00-13.00-96367

Drug C

12.30-13.00-96368

Some guidelines to follow PUSH coding

1.Minimum time to code initial time push is mins

2.For coding push of same drug there should be minimum 30 of mins time gap.

3.There is only one start time.

push

96374 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug

96375 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)

96376 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure)

Examples :

Drug A : 9.00 -96374

Drug B  : 9.15-96375

Drug B : 10.00-96376

Some guidelines to follow HYDRATION coding

1.There should be direct supervision for purpose of consent, safety oversight.

2.Minimum time to code infusion hydration 31 mins

HYDRATION

96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour

96361 Intravenous infusion, hydration; each additional hour (List separately in addition to code for primary procedure)

Examples:

¨Drug A : 10.00-12.00-96360,96361

¨Drug C : 12.00-12.30-No code for hydration as timing is not met

¨Infusion and hydration given in same time code only infusion. Hydration is included.

¨Drug D infusion : 7.00-8.00-96365

¨Drug D hydration: 7.00-8.00-no code

Intramuscular

96372 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular

Examples :

1. 7.00pm Demerol with Phenergan IM given in LD-96372*1
2. 7.00pm Demerol IM LD (left deltoid) 7.00pm Phenergan IM RD (right deltoid)-96372*2

Inhalation:

¨94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction for therapeutic purposes and/or for diagnostic purposes such as sputum induction with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (IPPB) device

 

Example :

¨Albuterol given as IH -94640

 

Note:

Suppose  for a patient all three infusions are reported on same date of service i.e infusion, push and hydration is given report the initial service and second service or second code should not be initial code of second service it should be add on code

Drug B push :11.00-96374

Drug C Hydration: 11.00-12.00-96361.

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