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Answer: The surgeon can bill separately for the IV using 36410 (venipuncture necessitating a physician's skill [separate procedure], for diagnostic or therapeutic purposes) in addition to the appropriate-level hospital admission code (99221-99223), says Kathleen Mueller, RN, CPC, CCS-P, an independent general surgery coding and reimbursement specialist in Lenzburg, Ill.
Until this year, there was no code for the insertion of a nasogastric tube by a physician, and the service was included in whatever E/M service was also provided (in this case, an admission). CPT 2001 introduced a new code (43752, naso- or oro-gastric tube placement, necessitating physician's skill), but HCFA has indicated it will not pay for this service and the Medicare fee schedule assigns no relative value units to this code -- making it unlikely the surgeon will get paid for this procedure.
If 36410 and/or 43752 are billed, don't forget to append modifier -25 (significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to the correct admission code, Mueller adds.
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