ED Coding & Reimbursement Alert - 2008 Issue 5
PART B MYTHBUSTER: Shatter These 4 'Push' Myths to Create Pristine Claims
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Article Overview
This article addresses common myths affecting intravenous push and infusion reporting in Part B claims. It is aimed at coders, billers, and billing compliance staff working with CPT and HCPCS Level II drug reporting. The discussion focuses on broad guidance around administration timing, initial versus subsequent services, concurrent service concepts, and documentation considerations.
Why This Topic Matters
Accurate reporting of infusion and push services can affect claim integrity and reduce avoidable errors in outpatient and physician billing. The article helps readers understand the general categories of guidance that influence correct claim preparation.
Article Sections
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Steer clear of this common concurrent coding misdeed
Introduces the article’s focus on common misunderstandings in administration coding and claim preparation. Sets up the broader discussion of IV push and infusion reporting.
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Myth 1: Count to 15 for every push.
Discusses timing-related misconceptions about push reporting and general criteria used to recognize a push service. Explains the broader distinction between time-based and observation-based concepts.
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Myth 2: Report initial push/initial infusion together.
Covers the relationship between initial administration services and encounter-level selection. Includes discussion of documentation, service sequencing, and a narrow exception involving separate IV sites.
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Myth 3: Report 2 units for 2 pushes of 1 drug.
Addresses unit reporting concepts for repeated administrations of a substance during one encounter. Focuses on how single-substance administration is reflected in reporting.
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Myth 4: Claim concurrent code for infusion/push.
Explains the distinction between concurrent infusion concepts and a push performed during an infusion. Includes a general example involving infusion services and separately reported drug products.
What You Will Learn
- How IV push and infusion reporting are discussed in relation to timing and administration method
- How initial and subsequent administration services are distinguished at a high level
- How repeated administrations during an encounter affect unit reporting concepts
- How infusion, push, and concurrent administration concepts differ in claim reporting
- What kinds of documentation issues are emphasized for administration coding
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Oncology coding specialists
- Outpatient facility coders
- Physician practice coders
Codes Discussed
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