Health Information Management

Bill one initial drug administration code per encounter, regardless of duration

APCs Insider, February 2, 2007

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Bill one initial drug administration code per encounter, regardless of duration

QUESTION: Regarding IV infusions: Is it appropriate to charge an initial code for each date of service during an encounter/visit, or should we only report one initial code during the entire encounter/visit?

ANSWER: CPT states the following: "When administering multiple infusions, injections or combinations, only one "initial" service code should be reported, unless protocol requires that two separate IV sites must be used. The "initial" code that best describes the key or primary reason for the encounter should always be reported..."

Therefore, only report one "initial" code per encounter (keeping the above exception in mind). CMS clarified on the last Hospital Open Door Forum Call that when a provider starts an infusion, and that patient encounter continues over one or two days, treat it as one encounter. Report all charges for observation hours and infusion services using the admitting date of service. This rule of "only one initial service" therefore includes observation cases that include more than one date of service.



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