Diagnosis codes are used by hospitals, doctors and other health care service providers to bill for services to insurance companies. Any type of service performed by a health care provider, regardless of location, must be noted on an insurance claim form if the service provider wishes to be reimbursed for such services. These services are designated by codes, or sets of numbers determined by regulatory associations that provide detailed information regarding types of services, supplies, drugs or other items involved in the care of a patient.
Function
Medical codes specifically identify the types of services offered by a medical office, clinic or hospital. Codes are required by the CMS (Centers for Medicare and Medicaid Services) for repayment or reimbursement of services provided by health care professionals. Codes are designed to prevent billing errors that may slow or deny reimbursement, and must be accurately designated on medical claim forms.
Types
Medical codes cover surgeries, diagnostic, medicine, and therapeutic procedures in all areas of medical care, including mental health and substance abuse treatments. Codes for physicians offices are found in the Current Procedural Terminology (CPT) published yearly with updates by the American Medical Association, while hospital services and codes are found in the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) manual.
Types of Infusion Therapy
Several types of intravenous (IV) infusion therapy are found in the CPT, among them diagnostic or prophylactic and therapeutic. These types of infusions are for the administration of drugs or other substances other than for hydration. Such services require the direct supervision of a physician, whose time and specific actions or duties or services will also be specified with medical codes.
CPT Codes for Intravenous Infusion Therapy
According to the CPT 2009, infusion hydration codes are listed as 96360 for intravenous infusion for hydration for 31 minutes to an hour. Code 96361 designates hydration infusion for each additional hour. Intravenous infusion for therapy, prophylaxis or diagnosis for up to one hour is designated by code 96365, while each additional hour is designated by using code 96366.
Intravenous infusion for therapy, diagnosis or prophylaxis for additional infusions are to be listed separately. For example, in addition to the code for primary procedures for up to one hour (code 96367), intravenous infusion therapy for concurrent infusion (code 96368) would also be listed.
Updates
Refer to code revisions and updates via the American Medical Association website updates or newsletters. CPT changes are published yearly and are available for purchase through the American Medical Association and the American Academy of Professional Coders as well as online bookstores such as Amazon.
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