tci ED Coding & Reimbursement Alert - 2004 Issue 11

Reader Question: Append -52 for Extra Infusion Time

Question: What guidelines govern reporting a patient who receives less than two full hours of intravenous infusion in the ED? In other words, should we bill CPT 90780 for the first hour and 90781 for the second hour? Should we round up or down if the time is more than or less than 30 minutes, and add modifier -52?Wyoming Subscribe Answer: The CPT book does not specifically address this question with thresholds for minimum time requirements to report these services, as it does for critical care services. However, CPT Assistant states, "In the instance when an infusion lasts...

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