General Question for the Week of June 19, 2023

Question:

We use 96360 and 96361 for hydration fluids administered in radiology. These codes often edit against the CT procedure code. What modifier would you recommend? Regarding the question of an appropriate modifier for billing of hydration therapy with a CT scan, we should clarify that we are billing for a hospital radiology dept.

Answer:

IV fluids are often given as prophylaxis to prevent AKI prior to IV contrast administration. A patient may be at high risk of contrast-induced acute kidney injury, and documentation supports the medical indication for hydration before and / or after the CT scan, then hydration therapy may be coded. In this scenario, it would be appropriate to append modifier 59 (or modifier XU as applicable) to the administration code for hydration therapy since the infusion was a distinct procedural service from the CT scan.

This question was answered in our annual Hospital Outpatient Infusion Services: Reimbursement & Compliance Update webcast. For more hot topics relating to infusion services, please visit our store or call us at 1.800.252.1578, ext. 2.