Hydration

Hydration is not separately billable when it's:

  • For purpose of keeping open a vein; and/or
  • An integral part of a service

View the below related information on this page.

Integral Part of a Service

Intravenous (IV) sites started in the Emergency Department (ED), for the purpose of providing hydration, are allowable; however, the beneficiary must present with signs and/or symptoms that warrant the billing of hydration. These signs and/or symptoms must be documented in the medical record to substantiate the need for hydration and to be reimbursed by Medicare.

If the purpose of starting the IV is to administer another drug, which requires hydration (i.e., the drug indication directs the administration be done with hydration to prevent toxicity), then the hydration is an integral part of the primary medication and is not separately billable.

If a surgical procedure is being performed in which hydration is needed, the hydration is considered an integral part of the surgical procedure being performed and therefore not separately billable.

Documentation

To properly document the signs and/or symptoms requiring hydration services, review the Medical Documentation Required section of the Noridian Hydration Services Coverage Article.

Order for Hydration

An order for hydration is required; however, the practitioner is not required to specify the exact verbiage of "order" in the record. Examples of an order for hydration may include, but are not limited to:

  • Normal saline to run at 150cc/hr for 3 hours;
  • Normal saline one liter over 2.5 hrs; or
  • D5-1/2 normal saline +30 mg EqKC1/liter and give one liter over 2 hours.

If it is documented in the medical record that the beneficiary cannot take anything by mouth, the signs and/or symptoms must still be documented, and an order written, to support the medical necessity of the hydration services.

Billing

Current Procedural Terminology (CPT®) defines hydration by two codes:

  • 96360
    • Intravenous infusion, hydration; initial, 31 minutes to 1 hour.
      • Do not report 96360 if performed as a concurrent infusion service.
      • Do not report intravenous infusion for hydration of 30 minutes or less.
  • 96361
    • Each additional hour (List separately in addition to code for primary procedure).
      • Use 96361 in conjunction with 96360.
      • Report 96361 for hydration infusion intervals of greater than 30 minutes beyond 1-hour increments.
      • Report 96361 to identify hydration if provided as a secondary or subsequent service after a different initial service [96360, 96365, 96374, 96409, 96413] is administered through the same IV access.

For related information on hydration, view the Chemotherapy Administration Billing webpage.

Resources

Last Updated Fri, 18 Jan 2019 08:57:48 +0000