IV Coding

IV Coding Scenario #1

A 25-year-old male falls from a pickup truck bed. Ambulance arrives at 15:56 with an IV running.  He complains of knee pain, a headache and shoulder pain.  Bystanders thought he had a seizure that lasted only 1 or 2 minutes. He cannot bear weight on the injured knee and has limited mobility of the injured shoulder. He also has multiple abrasions on his anterior scalp, knee and both hands. He is brought back to the treatment area immediately on arrival.  30 minutes after arrival he experienced a witnessed grand mal seizure lasting about 3 minutes. He has been given Valium 4mg IV push to treat his seizure. After being stabilized, he was sent to MRI for a head scan.

  • A large bore IV line has been started by the paramedic while initial field evaluation was being performed.  The ambulance arrived at 15:56.  The IV is running at a rate of 500 cc per hour and there is approximately 600 cc remaining in the bag.
  • The physician orders the IV to be continued at 250cc while continuing to evaluate the patient’s injuries.  The IV is stopped at 18:22.
  • A second bag of Normal Saline is hung at the same rate of 250cc per hour at 18:34 and continued until the patient is admitted at 22:01.
  • Dilaudid, 4mg, (Pain medication) is administered via IV push 10 minutes after arrival.
  • Valium 4mg was administered by IV push at 16:34.
  • The Dilaudid is repeated at 16:40.
  • The patient is given a Dilantin loading by IV infusion.  It is started at 17:03 and stopped at 19:48 (what is the duration in minutes?)

What are the expected IV service code(s)?

IV Coding Scenario #2

A 42-year-old male comes complaining of severe flank pain. He has no history of recent trauma but has passed kidney stones in the past.  An IV line is placed at KVO at 10:21 by the admitting nurse. Treatment course is outlined below.

  • Pain medication, Dilaudid 2 mg, administered via IV push 20 at 10:24.
  • Dilaudid 2 mg is repeated at 10:30.
  • IV hydration is ordered at 10:30 with Normal Saline at 500 cc hour.  It is started at 10:42 by the staff nurse and is completed at 11:45.
  • Dilaudid 2 mg is ordered again at 11:50.
  • IV hydration is ordered to be continued for another liter of Normal Saline with 40MEQ of Potassium at a rate of 250 cc per hour..  The IV fluid is started at 11:55 and continued until 15:22.

What are the expected IV services code(s)?