Infusion Coding Services

Infusion coding services are not easy to handle. It requires adequate knowledge, constant awareness of changing codes and experience.

When it comes to coding infusions and injections, providers must follow the proper CPT guidelines. The infusion and injection billing services are determined based on two factors- whether the services are reported by a physician or a facility. In most cases, physicians and facilities may report only one service code unless the patient’s condition or protocol requires two intravenous (IV) sites. The time and effort differences in providing the second IV site should be reported using the initial service code and an accurate modifier.

Managing infusion billing and coding services in fact is a great deal. You not only need to look after multiple aspects like specific billing requirements, covering the right CPT codes/HCPCS description, chemotherapy administration, infusion start/stop time, hydration infusions drug administration, IV push start/stop time but also various other limitations and exclusions in the medical records. Also it is important to know that drug administration codes are services that reference time and are “time based” codes

A proper hierarchy should be maintained in infusion coding support to bill the maximum amount of revenue. For example – Chemotherapy drugs come first, followed by therapeutic drugs, and then hydration drugs—the quantity of each is directly determined by the duration of the infusion.


Key challenges faced by most infusion centers in United States:

In the intricate domain of medical coding, infusion coding stands out as a challenging area. With limited experience and knowledge in the healthcare industry, infusion professionals often face the following challenges-

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  • Precision problem in coding duration
  • Documentation related to specific drugs
  • Navigating complex coding guidelines
  • Documentation complexity
  • Adherence to regulatory updates
  • Coding for different scenarios

 Some interesting infusion coding factors –

When you bill IV hydration along with IV pushes, always report the IV push as the initial code. According to the CPT hierarchy, the initial code must be 96374.

  • Following that code, 96361 must be assigned for the hydration.
  • The CPT hierarchy is based on the instructional notes found in the CPT book. You need to see parenthetical notes following both 96374 and 96361

Concurrent codes are not to be used for multiple drugs within the same bag

  • Typically concurrent is used for “gravity drip” infusion methods

96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour
96361 Intravenous infusion, hydration; each additional hour (list separately in addition to primary code)

Like other infusion practices, if you are also sharing the common ache then, outsource coding services for infusion practices is the best alternative solution today. Outsourcing to one of the best infusion coding companies or expert will not only help you save time but also reduce your claims denials rate and make your coding and billing process way easy.

 Now, you might have realized that infusion coding requires substantial time and effort. And outpatient infusion coding requirements are more complex than in-patient setting. It is best to have dedicated resources managing your infusion coding services.

Sunknowledge: A comprehensive infusion coding support:

With more than a decade of experience in the medical billing domain, we always ensure accurate and complete infusion and injection coding. At Sunknowlege, we are highly equipped and experts to provide timely and accurate infusion coding services to receive maximum reimbursement for your practice.

With nearly 17+ years of experience, we understand the intricacies of optimizing your entire medical billing infrastructure. Our team possesses comprehensive knowledge and expertise in managing various CPT, ICD-10, and HCPCS codes associated with infusion and injection, including the latest modifiers. Our certified coders consistently stay informed about the most recent guidelines and coding domain changes to provide you with accurate and up-to-date services.

Why us as your Infusion Coding Support-

  • Timely and precise delivery of charge sheets within client-specified turnaround time (TAT)
  • Continuous monitoring, analysis, and assignment of accurate codes to prevent potential denials and ensure optimal reimbursements
  • Ongoing training for certified coders to stay updated with the latest infusion coding advancements and current practices
  • Emphasis on a prompt report-back mechanism to facilitate efficient communication
  • All coders hold ICD-10 certification, showcasing their expertise and proficiency
  • Consistent maintenance of a 99.9% coding accuracy rate
  • Adherence to 100% HIPAA compliance, prioritizing the security and confidentiality of patient information.

As a New York-based leading RCM company, we enable you to slash your operational costs by almost 80% in no time. If you are looking to streamline your infusion coding services expenses while enjoying improved cash flow, we are your ready-to-go partner.

We also offer infusion billing, prior authorization services, claims management, accounts receivable, payment posting and remote office assistance services and more. If you want to know more about our services, schedule a no-obligation call with us.

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