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Tag Archives: infusion

Straighten Out the Kinks in Your Infusion Road Map

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Navigate with ease through the complexity of non-chemotherapy infusion encounters. Coding infusion services can seem as complicated as driving to an unknown destination without GPS, especially when there are multiple medications. Whenever you’re feeling lost, use this road map for facility-based billing of non-chemotherapy medications to find your way to proper payment. First Stop: Hierarchies […]

The post Straighten Out the Kinks in Your Infusion Road Map appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Infusion Dictation

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Can anyone point me towards a document with official rules for whats needed to legally bill an infusion. All of a sudden I have providers that do not want to dictate their normal infusion note. They are suggesting that if a nurse documents a conversation between themselves and a doctor that that is enough to bill. It is also being suggested that if I receive an order from a provider that DOES NOT work for our clinic, that that is also enough to bill an infusion. I err on the side of…documentation of a conversation is NOT enough and how am I going to bill for pur practice based upon what a different doctor in a whole different city states? Thoughts?

Medical Billing and Coding Forum

Restarted Infusion Without Documented Stop BEforehand

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Hello All,

I’m hoping to get some opinions regarding how to handle an unusual documented infusion entry. The patient received an infusion of lactated ringers, with frequency documented as Continuous. The times are documented as follows:

3/19 1117 New Bag 100mL/hr
3/19 1338 New Bag 100mL/hr
3/19 1444 Rate/Dose Verify 100mL/hr
3/19 2051 New Bag 100mL/hr
3/20 0028 Rate/Dose Verify 100mL/hr
3/20 0343 Restarted 100mL/hr
3/20 0613 Canceled Entry 100mL/hr
3/20 0614 Stopped 0mL/hr
3/20 0628 New Bag 100mL/hr

Normally, since this was documented as a continuous frequency infusion, I would count from the first entry on 3/19 1117 through 3/20 at 0614; However, with the "Restarted" entry and no "Stopped" time before that, I think I can only charge from the Restarted Time of 3/20 0343 through the Stopped Time 3/20 0614. The other question we had was whether the documented infusion time prior to the "Restarted" entry can be coded at all, mainly as IV pushes as opposed to infusion.

I appreciate any suggestions you may have :)

Tracy

Medical Billing and Coding Forum

billing for Hydration code 96361, when not the primary infusion

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An IV Push and 2 hrs of Hydration was given at this visit.
Since we need to bill only 1 initial, I chose 96374 for the Iv push and 96361*2 for the 2 hrs of hydration.
Is that correct.?

If hydration was the primary code, then it would be 96360 and 96361.

Thanks

Medical Billing and Coding Forum

Infusion 25 mins in Clinic- rest with Ambulance transport – billable?

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Thoughts?
Patient seen in clinic with saline infusion started. Time of 25 mins of infusion provided – with continuation of this during ambulance ride to hospital.
Billable on the clinic side? Thanks!!

Nursing documentation :
A #20 gauge catheter was started in his left forearm. There was a good blood return. 250 cc’s of 0.9 Normal Saline was then started per pump and infused over 1 hours. The patient tolerated the treatment well. Start time 1315. Stop time 1340.

The pt was transported to hospital as a direct admit via ambulance. The EMTs took the IV bag of 0.9 Normal Saline with the pt to finish giving it to him in the ambulance.

==

Medical Billing and Coding Forum

Help with infusion codes

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Toradol- 15mg- 4:20 to 4:20 IV push
Zofran- 4mg, – 4:20 to 4:22 IV push
Toradol- 15mg – 5:57 to 5:57 IV push

I coded the following.
96374- initial IVP for Toradol
96375*2- additional IVP for Zofran and Toradol

We are physician group, not facility.
So per cpt, I cannot bill 96376.

My question is can I bill 96375*2 for the additional Toradol administration?

Thanks

Medical Billing and Coding Forum

Infusion Therapy Reimbursements

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Hi All, Just wanted to get some data of what Infusion therapy reimbursements are from the major payers in CA. I have a Dr. who is looking into adding this service to his medical practice but dont have any personal historical data of what the insurance companies are paying. Any feed back would be greatly appreciated.

Thank you,

CoderB

Medical Billing and Coding Forum

Infusion + shots

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We have pt that comes in regularly for Xolair injections and we bill and are paid billing it as follows:

96372-RT
96372-LT
96372-RT/59

This pt recently came in for Reclast infusion on same date as Xolair injections. We billed as follows:

J3489 – paid by BCBS
96365 – paid by BCBS
96372-RT – DENIED
96372-LT – DENIED
96372-RT/59 – paid by BCBS

The denial on the two 96372’s denied was CO-97 – This service/procedure is included in a service already paid.

Can anyone tell me how to get the entire claim paid?

Thanks for any assistance you can provide!

Hunter Smith, CPC

Medical Billing and Coding Forum

Billing observation hours and infusion hours

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I was taught not to bill observation hours in conjunction with infusion hours but I can’t find this in writing. There are a few older posts (2009) that state you can’t bill chemo administration and blood transfusion with the G0378. Can someone clarify this and add their source. Thank you in advance.

Medical Billing and Coding Forum