Health Information Management

Consider pre-filled saline syringes to be packaged supplies

APCs Insider, November 9, 2007

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QUESTION: Can we bill for the pre-filled saline syringe that a provider uses at the conclusion of an intravenous medication administration? I know that we cannot bill the actual task of flushing, according to the Medicare Claims Processing Manual 100-4, Chapter 12, Section 30.5, C. If we can bill for the pre-filled saline syringe, should we consider it to be a supply or a drug?

ANSWER: The pre-filled saline syringe used to flush the venous access is reportable as a packaged supply on a claim, assuming you have not already included it in the infusion charge. Medicare does not separately reimburse this supply item, but charge-based payers do pay for it.

Your hospital procedures will dictate whether you bill the flush syringe under a supply revenue code (27X) or a pharmacy revenue code (25X). Many hospitals dispense the saline flush from the pharmacy, while others may consider this a supply and distribute the saline flush from the materials supply department. Either method would be appropriate. Keep in mind that anything you bill must be documented in the medical record.

(The above Q&A appeared in the December 2007 issue of APC Answer Letter).

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