CCO Admin asked:
Hi! I found this in AAPC website; "If you are charging a 96360; 96365 or 96374; you do NOT code for the IV start (36000) as it is already included in the initial procedure." Do you have any supporting statement from AMA regarding this?
Answer:
**AMA Guidelines:**
> Physician or other qualified health care professional work related to hydration; injection; and infusion services predominantly involves affirmation of treatment plan and direct supervision of staff.
>
> Codes [96360](https://www.findacode.com/code.php?set=CPT&c=96360)-[96379](https://www.findacode.com/code.php?set=CPT&c=96379); [96401](https://www.findacode.com/code.php?set=CPT&c=96401); [96402](https://www.findacode.com/code.php?set=CPT&c=96402); [96409](https://www.findacode.com/code.php?set=CPT&c=96409)-[96425](https://www.findacode.com/code.php?set=CPT&c=96425); [96521](https://www.findacode.com/code.php?set=CPT&c=96521)-[96523](https://www.findacode.com/code.php?set=CPT&c=96523) are not intended to be reported by the physician in the facility setting. If a significant; separately identifiable office or other outpatient Evaluation and Management service is performed; the appropriate E/M service ([99201](https://www.findacode.com/code.php?set=CPT&c=99201)-[99215](https://www.findacode.com/code.php?set=CPT&c=99215); [99241](https://www.findacode.com/code.php?set=CPT&c=99241)-[99245](https://www.findacode.com/code.php?set=CPT&c=99245);
[99354](https://www.findacode.com/code.php?set=CPT&c=99354)-[99355](https://www.findacode.com/code.php?set=CPT&c=99355)) should be reported using modifier 25 in addition to [96360](https://www.findacode.com/code.php?set=CPT&c=96360)-[96549](https://www.findacode.com/code.php?set=CPT&c=96549). For same day E/M service; a different diagnosis is not required.
>
> If performed to facilitate the infusion or injection; the following services are included and are not reported separately:
>
> a. Use of local anesthesia
>
> b. IV start
>
> c. Access to indwelling IV; subcutaneous catheter or port
>
> d. Flush at conclusion of infusion
>
> e. Standard tubing; syringes; and supplies
>
> (For declotting a catheter or port; use [36593](https://www.findacode.com/code.php?set=CPT&c=36593))
Hi! I found this in AAPC website; "If you are charging a 96360; 96365 or 96374; you do NOT code for the IV start (36000) as it is already included in the initial procedure." Do you have any supporting statement from AMA regarding this?
Answer:
**AMA Guidelines:**
> Physician or other qualified health care professional work related to hydration; injection; and infusion services predominantly involves affirmation of treatment plan and direct supervision of staff.
>
> Codes [96360](https://www.findacode.com/code.php?set=CPT&c=96360)-[96379](https://www.findacode.com/code.php?set=CPT&c=96379); [96401](https://www.findacode.com/code.php?set=CPT&c=96401); [96402](https://www.findacode.com/code.php?set=CPT&c=96402); [96409](https://www.findacode.com/code.php?set=CPT&c=96409)-[96425](https://www.findacode.com/code.php?set=CPT&c=96425); [96521](https://www.findacode.com/code.php?set=CPT&c=96521)-[96523](https://www.findacode.com/code.php?set=CPT&c=96523) are not intended to be reported by the physician in the facility setting. If a significant; separately identifiable office or other outpatient Evaluation and Management service is performed; the appropriate E/M service ([99201](https://www.findacode.com/code.php?set=CPT&c=99201)-[99215](https://www.findacode.com/code.php?set=CPT&c=99215); [99241](https://www.findacode.com/code.php?set=CPT&c=99241)-[99245](https://www.findacode.com/code.php?set=CPT&c=99245);
[99354](https://www.findacode.com/code.php?set=CPT&c=99354)-[99355](https://www.findacode.com/code.php?set=CPT&c=99355)) should be reported using modifier 25 in addition to [96360](https://www.findacode.com/code.php?set=CPT&c=96360)-[96549](https://www.findacode.com/code.php?set=CPT&c=96549). For same day E/M service; a different diagnosis is not required.
>
> If performed to facilitate the infusion or injection; the following services are included and are not reported separately:
>
> a. Use of local anesthesia
>
> b. IV start
>
> c. Access to indwelling IV; subcutaneous catheter or port
>
> d. Flush at conclusion of infusion
>
> e. Standard tubing; syringes; and supplies
>
> (For declotting a catheter or port; use [36593](https://www.findacode.com/code.php?set=CPT&c=36593))
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