Wiki 96365 billed?

[prirs1985]

For critical care, doctor ordered alteplase-open cath for patient, but didn't document that doctor started IV. Doctor wanted me to bill 99291-25 and 96365. Is this appropriate? Please advice.

 

[OncologyOKC]

Alteplase given for the purpose of occlusion is billed with 36593 (Declotting by thrombolytic agent of implanted vascular access device or catheter.) Alteplase is not infused but is simply pushed into the occluded dwelling and allowed to set to dissolve the occlusion.

 

[thomas7331]

Did this take place in a facility? 96365 is an incident-to code and isn't payable to a physician in a hospital setting. A physician also may not bill incident to in a facility so may not bill for services just ordered and not personally performed. If by odd chance this took place in the physician's own office and was performed by his or her own ancillary staff, then it could potentially be billed this way if documentation supported it.