Wiki Bundled Code Fem Tap + Lumbar Tap

venitacason

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Good afternoon,

Our group submitted a claim:
99233.25 Inpatient, Subsequent, High Complexity
62270 Lumbar Tap
36400 Fem stick**

The insurance is denying 36400 because the payment is included with the 62270 services. They are bundling the codes. They are two separate procedures for separate diagnoses codes. Has anyone else ever ran into this problem? Are these bundled?

UPDATE FOR ANYONE ELSE WHO EVER RUNS IN TO THIS PROBLEM. LEARNING OPPORTUNITY FOR ME!: 36400 (Fem Stick) was not bundled with 62270 (Lumbar Tap) services it was paid under the 99233 (inpatient hospital stay) because it is technically a blood draw. This is done for patients who have a small veins or for patients who have a difficult time getting blood drawn peripherally. Central vein (femoral) vs peripheral vein (hands, arms) (36415) which is covered under a hospital stay.

Central draws require physician or other qualified healthcare professional.

Thank you,
Venita
 
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