Health Information Management

Q/A: Why are we hitting an edit for flushing a line?

APCs Insider, May 3, 2013

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Q: We are receiving errors on our scrubber software that we haven’t seen before. Our process is that we flush the line to ensure it is patent and then wait for pharmacy to send us the medication. They don’t mix it until we know that the port is patent because some have short shelf lives and if there is a problem, we may have to waste the drug. When pharmacy sends the medication, we start the infusion. We haven’t changed our charging process but are now receiving edits. Can you help us?

A: It appears that your software has activated an edit based on instructions in the National Correct Coding Initiative (NCCI) manual. Chapter 11 notes:
Flushing or irrigation of an implanted vascular access port or device of a drug delivery system prior to or subsequent to the administration of chemotherapeutic or non-chemotherapeutic drugs is integral to the drug administration service and is not separately reportable. Do not report CPT code 96523.
Because the instructions explicitly state not to report the code for the flushing of the device, the edit is correct. You should include the cost of this in the first hour of infusion to capture the cost if it isn’t included already. Check with your finance or cost accounting department to validate if these resources are already included in the charge.
Editor’s note: Denise Williams, RN, CPC-H, vice president of revenue integrity services at Health Revenue Assurance Associates, Inc., in Plantation, Fla., answered this question.

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