Are you having trouble with getting Hydration services paid? Are you billing for each increment correctly? Well, no worries, you are not a dummy you are just a part of a much larger group of folks who are very smart but don’t really know how to bill for Hydration service in their clinic. So, I have asked our Coding Leadership Team to explain this in simple terms. Below are the guidelines that she shared with us. Please remember that you should always confirm with your specific payors regarding any additional instructions and/or special processes they may want you to follow.
Hydration is a prepackaged fluid and electrolytes (normal saline). IV Infusion is for the administration of substance or drugs when fluids are used to administer the drugs.
IV Push is for the administration of a substance or drug-taking less than 15 minutes. For Hydration/Infusion services you can only have one initial service, per encounter, unless protocol requires two separate IV sites. Sequential administrations are an infusion or IV Push of a new substance or drug following the initial service.
Keeping in mind that these are time codes. Time documentation is a must.
- Single IV Push = 1-14 minutes (<15 minutes).
- 16-60 minutes = 1-hour Infusion.
- 60-90 minutes = 1-hour Infusion.
- 91 minutes = 2-hour Infusion.
- 31-60 minutes = 1-hour Hydration.
- 60-90 minutes = 1-hour Hydration.
- 91 minutes = 2-hour Hydration.
Hydration Codes:
96360 – IV Hydration Initial 31 minutes to 1 hour.
+96361 – IV Hydration each additional hour – use after 91 minutes for additional time.
IV Infusion Codes:
96365 -Â IV Infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug)Â initial, up to 1 hour.
+96366 – each additional hour – use after 91 minutes.
+96367 – Additional, sequential IV Infusion of a new drug/substance, up to 1 hour (15 minutes to 1 hour).
IV Push Codes:
96374 – IV Push single or initial substance or drug.
+96375 – IV Push each additional, sequential intravenous push of a new substance or drug (List separately in addition to code for primary procedure).
Example Scenario 1:
The provider orders Saline Hydration, 45 minutes and IV Push for Zofran, 2 minutes.
Coding Example:
96360 for the Initial service for hydration.
J7030 for 1000c of Saline.
96365 for the sequential service.
J2405 for Zofran.
Example Scenario 2:
The provider orders IV Infusion for Clindamycin, 67 minutes and IV Push for Zofran, 2 minutes.
Coding Example:
96365 for the initial service for IV infusion.
S0077 for Clindamycin.
96365 for the sequential service.
J2405 for Zofran.
The above codes and guidelines are accurate as of the date of this post. If you have concerns about how to bill for hydration services, reach out to us [HERE]. We can help!
