Cardiology Coding Alert

Answer: CPT and Medicare do not bundle 36489 (placement of central venous catheter [subclavian, jugular, or other vein] [e.g., for central venous pressure, hyperalimentation, hemodialysis, or chemotherapy]; percutaneous, over age 2) with 99291 (critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes) or 99292 (each additional 30 minutes), says Wanda Oplinger, CPC, a coding and reimbursement specialist with Cardiology Consultants Ltd. in Belleville, Ill. Code 36489 may be reported separately from any critical care services provided.

But 93010 (electrocardiogram, routine ECG with at least 12 leads; interpretation and report only) is considered a component of critical care. The code itself is not specifically cited in the introduction to the critical care services in CPT 2000s evaluation and management section, which lists the following services as included in critical care services performed by a physician: the interpretation of cardiac output measurements (93561, 93562); chest x-rays (71010, 71020); blood gases (no codes provided); information data stored in computers (e.g., ECGs, blood pressures, hematologic data [99090]); gastric intubation (91105); temporary transcutaneous pacing (92953); ventilator management (94656, 94657, 94660, 94662); and vascular access procedures (36000, 36410, 36415, 36600)]. Any services performed that are not listed above should be reported separately.