36561, 76937, & 77001

[nlbarnes]

Can both 76937 & 77001 be billed w/36561? There isn't a CCI edit however I'm being told that both 76937 & 77001 can't be billed here.

Under ultrasound guidance, the right internal
jugular was identified. Local anesthetic was administered. A skin
nick was made with an 11 blade. The internal jugular was accessed
with a microcatheter kit. The J-wire of the port kit was placed
through the microcatheter sheath. Confirmation ultrasound was
performed. The chest wall and right neck were anesthetized with local
anesthesia. An incision was made in the skin of the upper right chest
at the midclavicular line and carried down to the fascia. The port
tubing was tunneled from the chest wall incision to the neck incision.
The port was secured in place with 3-0 Ethibond suture. The micro
sheath was exchanged for a peel-away sheath. The port tubing was cut
to length. The port tubing was inserted and confirmation fluoroscopy
was performed.

 

[Bwray]

I always bill for both 76937 (guidewire insertion and catheter tunneling) and 77001 (checks the positioning of the catheter tip), but I'm curious to see what other coders think about this.

 

[reds2250]

Hi I believe that CPT 36561 can be billed with 76937 for the US guidance however the fluoroscopy to verify tip placement 77001 is included in the 36561 procedure. If Fluoroscopy was used INSTEAD of US guidance, then you would properly bill 77001. I don't think that 76937 and 77001 can both be billed in this scenario. Thanks.