S5013 HCPCS Reimbursement & Policy Benchmarks | OpenPayer

Summary & Overview

HCPCS S5013: 5% Dextrose/0.45% Saline with Potassium and Magnesium, 1000 ml

HCPCS Level II code S5013 denotes a 1000 ml intravenous solution of 5% dextrose/0.45% normal saline combined with potassium chloride and magnesium sulfate. This combination fluid is used for simultaneous maintenance hydration and electrolyte repletion, making it relevant across acute care, inpatient, and outpatient infusion settings nationwide. The code identifies a specific furnished product rather than a standalone procedure, which affects supply billing and facility charge capture.

Key payers in the national context include Aetna, Blue Cross Blue Shield plans, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for appropriate use cases, guidance on service-line and site-of-service alignment, and an outline of typical payer coverage considerations and billing practices. The publication summarizes benchmarks and billing implications relevant to hospital supply and infusion service lines, highlights common modifier usage where applicable, and notes where input data are not provided. The material is intended for revenue cycle, infusion pharmacy, and clinical billing teams seeking clear, nationally applicable information about use and billing classification of this packaged intravenous solution.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareS5013HCPCS Level IIintravenous fluidelectrolyte replacementinfusion serviceshospital supplydextrose-salinepotassium supplementationmagnesium supplementationIV therapy

Billing Code Overview

HCPCS Level II code S5013 describes an intravenous fluid solution: 5% dextrose/0.45% normal saline with potassium chloride and magnesium sulfate, 1000 ml. This product is an electrolyte-containing dextrose solution used for fluid and electrolyte replacement, often when both potassium and magnesium supplementation are required alongside maintenance or free-water needs.

Service type: Intravenous infusion of a compounded/packaged crystalloid solution
Typical site of service: Hospital inpatient and outpatient infusion settings, emergency department, and observation units

Clinical & Coding Specifications

Clinical Context

A 62-year-old hospitalized patient with hypokalemia and mild hypomagnesemia is receiving maintenance intravenous fluids and electrolyte repletion. The ordered infusion is S5013 — 5% dextrose/0.45% normal saline with potassium chloride and magnesium sulfate, 1000 ml — administered via a peripheral IV or existing central access over several hours. Typical indications include replacement of potassium and magnesium in patients unable to tolerate oral intake, postoperative electrolyte repletion, or ongoing losses from gastrointestinal output or diuretics. Nursing documents baseline vitals, IV patency, infusion start time, infusion rate, total volume administered, and pre- and post-infusion serum potassium and magnesium levels. Pharmacy verifies concentration and admixture stability, prepares the bag under aseptic conditions, and labels the product. Billing is submitted under the HCPCS Level II code S5013 with applicable facility or professional modifiers per payer rules.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier	Use when no specific modifier applies.
`22`

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HCPCS-S2060-LOBAR-LUNG-TRANSPLANTATION

HCPCS Level II S2060: Lobar Lung Transplantation

HCPCS-S2202-ECHOSCLEROTHERAPY-ULTRASOUND-GUIDED-SCLEROTHERAPY

HCPCS S2202: Echosclerotherapy

HCPCS-S0618-AUDIOMETRY-HEARING-AID-EVALUATION

HCPCS S0618: Audiometry for Hearing Aid Evaluation

HCPCS-S9088-URGENT-CARE-CENTER-SERVICES

HCPCS Level II S9088: Urgent Care Center Services

HCPCS-S1090-MOMETASONE-SINUS-IMPLANT-370-MCG

HCPCS S1090: Mometasone Furoate Sinus Implant, 370 mcg

HCPCS-S5170-HOME-DELIVERED-MEAL-PER-MEAL

HCPCS Level II S5170: Home Delivered Meals, Per Meal

HCPCS-S0274-NURSE-PRACTITIONER-HOME-VISIT

HCPCS S0274: Nurse Practitioner Visit at Member's Home

HCPCS-S0080-PENTAMIDINE-300MG-INJECTION

HCPCS S0080: Pentamidine Isethionate Injection, 300 mg

HCPCS-S0255-HOSPICE-REFERRAL-VISIT-NURSE-SOCIAL-WORKER-COUNSELING

HCPCS S0255: Hospice Referral Visit by Nurse or Social Worker

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Taxonomy Code	Specialty	Notes
`350100000X`	Hospitalist	Commonly orders and manages inpatient IV electrolyte replacement and fluids.
`207R00000X`	Internal Medicine	Manages medical indications for electrolyte repletion and ongoing care.
`230400000X`	Critical Care Medicine	Manages complex infusions in ICU patients requiring electrolyte and fluid management.
`163W00000X`	Emergency Medicine	Initiates IV fluid and electrolyte therapy in the ED prior to admission or discharge.
`363A00000X`	Pharmacy	Clinical pharmacists verify admixture, concentrations, compatibility, and dosing.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`E87.6`	Hypokalemia	Primary indication for potassium-containing IV fluids when oral replacement is not feasible or when rapid repletion is required.
`E83.42`	Hypomagnesemia	Indicates need for magnesium sulfate supplementation often co-administered with potassium to correct refractory hypokalemia.
`E86.0`	Dehydration	IV fluids with dextrose and saline are used to treat volume depletion and provide electrolytes.
`K52.9`	Noninfective gastroenteritis and colitis, unspecified	GI losses causing electrolyte depletion may necessitate IV electrolyte replacement.
`N17.9`	Acute kidney failure, unspecified	Patients with renal dysfunction may require careful IV electrolyte and fluid management; dosing and rates adjusted per renal status.
`I95.1`	Orthostatic hypotension	When hypotension is related to volume depletion, IV fluids can be used for volume resuscitation and electrolyte correction.
`T80.89XA`	Other complications of infusion, initial encounter	Relevant for documentation if an adverse reaction or complication occurs during infusion administration.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96365`	Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour	May be billed when a therapeutic infusion is administered and infusion monitoring/documentation meets payer rules for initial infusion time.
`96366`	Intravenous infusion, each additional hour (list separately in addition to code for primary service)	Used to report additional hours of continuous infusion beyond the initial hour when time-based infusion services are billed.
`96413`	Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug	Relevant in settings where complex admixtures or chemotherapy concomitant infusions occur; not typical for `S5013` but may be billed alongside when chemotherapy protocols require electrolyte-containing carrier fluids.
`36415`	Collection of venous blood by venipuncture	Often performed before and after infusion to measure serum electrolytes (potassium, magnesium).
`96360`	Intravenous infusion, hydration; initial, 31 minutes to 1 hour	May be used when the primary service is hydration rather than therapeutic drug infusion and documentation supports hydration service.

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