Health Information Management

Guidelines to report multiple units of C8950

APCs Insider, March 3, 2006

Want to receive articles like this one in your inbox? Subscribe to APCs Insider!

Guidelines to report multiple units of C8950

QUESTION: Can we bill C8950 incrementally, meaning more than one unit of service per encounter? For example, a patient presents to the ED and the physician orders hydration therapy. The physician then orders IV antibiotics subsequent to the completion of the hydration. How should we report this encounter?

ANSWER: Think of C8950 as 2005 CPT code 90780. C8950 represents nonchemotherapy infusion, duration 16-90 minutes. Always report this code as a unit of one.

If the patient receives a subsequent infusion service through the same IV site, add the time together. If the total time exceeds 91 minutes, report C8951 with the appropriate units of service based on the total duration.

However, if a separate IV site is started and is medically necessary, report C8950 x 2 without a modifier to let Medicare know that two separate IV sites were started.

Per CMS Transmittal 785 (Changes to coding and payment for drug administration): "In the instance when infusions of the same type are provided through two vascular access sites of the same type in one encounter, hospitals may report two units of the appropriate first hour infusion code for the initial infusion hours without modifier -59."

Want to receive articles like this one in your inbox? Subscribe to APCs Insider!

    Briefings on APCs
  • Briefings on APCs

    Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...

  • HIM Briefings

    Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...

  • Briefings on Coding Compliance Strategies

    Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...

  • Briefings on HIPAA

    How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...

  • APCs Insider

    This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations...

Most Popular