Oncology & Hematology Coding Alert

Question: How can we get paid for port flushes? Can we bill for the supplies used for this service?

Kentucky Subscriber
 
 
Answer: Medicare will not pay for the flushing of an implantable venous access device, otherwise referred to as a port. It will also not pay for supplies, such as a Port-A-Cath kit, which includes a needle and catheter.
 
Accessing venous access devices for blood collection and/or Heparin flush for any reason is part of managing the patient with this type of long-term venous device and is included in the E/M code, 99211-99215. Supplies such as needles, syringes and Betadine wipes are also bundled with the E/M services.
 
Oncology practices should code the E/M service associated with the patient visit that included the port flush. Most often, a port flush is part of a nurse-only visit, so the proper code is 99211, the lowest-level E/M service. Higher levels of service must meet the criteria based on history, exam and medical decision-making. Also, the higher codes must involve face-to-face contact between the physician and patient. 
 -- Answers to You Be The Coder and Reader Questions provided by Elaine Towle, CMPE, practice administrator for New Hampshire Oncology and Hematology in Hooksett, N.H.; Imelda Lee, RHIA, CTR, coding supervisor with University Physicians Group at the University of Texas Health Science Center in San Antonio; and Margaret Hickey, MS, MSN, RN, OCN, CORLN, an independent coding consultant in New Orleans.