Health Information Management

IV pushes that last more than 15 minutes

APCs Insider, March 8, 2013

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A push is a push is a push. If I’ve heard Jugna Shah, MPH, say that once in relation to coding injections and infusions, I’ve heard her say a thousand times. But it’s still a good point to make.

So what is a push? The CPT® Manual defines an IV or intra-arterial push as:
  • An injection in which the healthcare professional who administers the substance/drug is continuously present to administer the injection and observe the patient
  • An infusion of 15 minutes or less
That second bullet is the one that seems to cause some confusion. People seem to understand that if an infusion runs for less than 15 minutes, they report the CPT code for a push, not as an infusion. The CPT codes for infusions all include a time element, usually one hour. That means you need at least 31 minutes of infusion time in order to report an infusion code.
 
If you don’t have stop times for infusions, you may be reporting a lot of them as pushes unless you are very comfortable defending an assumption about how long the infusion actually ran.
I’ve started hearing people ask whether they can report a push that last longer than 15 minutes as an infusion.
 
The short answer is NO. If the physician ordered a push and the nurse documented a push, you must code a push regardless of how long it lasted. You can’t upgrade it to an infusion.
 
Some people seem to think that because CPT instructs coders to report a push if the infusion lasts less than 15 minutes, that means they can report a push of longer than 15 minutes as an infusion. Again, NO!
 
I’m not sure how this started, but my guess is people are reading something into the CPT guidelines that just isn’t there. No one has yet stated that pushes can be upgraded to infusions. Not CPT, not CMS, not any third-party payer.
 
A push is a push is a push!



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