Wiki 36591 & 96523

[BoeJerger]

Patient comes in for labs. We cannot charge for the draw (36591). Can we charge for the flush (96523) as long as there was not an office visit or drug admin that same day? Medicare says "Irrigation of implanted venous access device for drug delivery systems (96523) will be paid if it is the only service provided that day. If there is a visit or other drug administration service provided on the same day, payment for 96523 is included in the payment for the other service." Are they defining service as drug admin or office visit only or do they include "labs" with service?

 

[AuntJoyce]

36591 and 96523

Hi Joe~

The bottom line is that a port flush can only be billed if it is the absolute only procedure performed. The catch in your situation is: is it your lab? Do you bill for the labs? If so, you can't capture the port flush. If it is an outside lab on your premises and they bill for their own services, then your side can capture the port flush.

Coding - sometimes I think flipping burgers is a whole lot less stressful (and I've never flipped burgers for a living)...lol

Hope this helps a little.

Joyce