星空入口

You Be the Coder: Are Infusions Separate During Observation Stay?

Question: May we report intravenous infusions and injections during a separately payable observation stay? If so, how?

Illinois Subscriber

Answer: Yes, you may report intravenous infusions and injections in addition to a properly delivered and coded observation stay (see "Learn the Limits of Facility Observation Coding" on page 33 for complete information on reporting facility observation services).

You should select the appropriate code to describe the intravenous infusion/injection service that the facility provides. For instance, for hydration services, you would select 90760 (Intravenous infusion, hydration; initial, 31 minutes to 1 hour: APC 0440) and +90761 (... each additional hour [list separately in addition to code for primary procedure]: APC 0437), as appropriate.

For initial infusion for therapy, prophylaxis or diagnosis, turn instead to 90765 (Intravenous infusion, for therapy, prophylaxis or diagnosis [specify substance or drug]; initial, up to 1 hour: APC 0440) and +90766 (... each additional hour [list separately in addition to code for primary procedure]: APC 0437).

For "secondary services," or additional sequential infusions, you would call on +90767 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; additional sequential infusion, up to 1 hour: APC 0437).

CPT describes subcutaneous infusions and therapeutic, prophylactic or diagnostic injections using dedicated code sets (90769-90771 and 90772-90776, respectively). For chemotherapy injections and intravenous infusion, you would select from yet another code set (96401-96417). For time-based infusion codes (such as 90760 and 90761), you should carefully record exact start and stop times.

Keep watching for a future edition of Ambulatory Coding and Payment Report for complete information on reporting intravenous infusion/injection procedures.