Q&A: CPT coding for multiple therapeutic infusions of short duration

Q: Sometimes providers at our facility perform multiple, separate administrations of hydration that are less than 30 minutes each. Can coders add the separate infusion times together when assigning time-based CPT codes for hydration administration?

A: No, coders must evaluate each infusion administration separately for the time it ran and then report applicable CPT codes. They can’t report hydration of 30 minutes or less with the hydration service CPT codes. However, these services may be reported with a revenue code and dollar charge.

For example, if the documentation specifies that hydration is administered for an hour and 15 minutes, the coder should report CPT code 96360 (intravenous infusion, hydration; initial, 31 minutes to 1 hour) for the encounter. He or she wouldn’t report the additional 15 minutes because the hydration service is less than 30 minutes past the initial hour.

Similarly, for therapeutic infusions, the coder should not add infusion times together. He or she must evaluate and report each separately; either as an infusion or, if short duration, as an injection.  

Coders may find it helpful to review the coding guidelines under the CPT Manual subsection “Hydration, Therapeutic, Prophylactic, Diagnostic, Injections and Infusions, and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration,” and the December 2011 CPT Assistant that clearly states these times should not be added together.

Editor’s note: Jugna Shah, MPH, president and founder of Nimitt Consulting in Washington D.C., and Valerie A. Rinkle, MPA, lead regulatory specialist with HCPro, a Simplify Compliance brand, in Middleton, Massachusetts, answered this question during the HCPro webinar, “Injections and Infusions: Resolve Frequent Coding and Billing Challenges.”

This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.

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