Hi all, I am new to IR world and took over coding in a hospital setting. We have a team of PICC nurses that want to start charging for midline insertions. As I understand it, to charge a true midline placement we would use code 36410. With that said, we are questioning whether we can use this code when the nurses do the work, based on the code description "necessitating the skill of a physician or other qualified health care professional".
The American Medical Association (AMA) established a definition for a qualified healthcare professional (QHP), in terms of which providers may report medical services:
“A ‘physician or other qualified health care professional’ is an individual who is qualified by education, training, licensure/regulation (when applicable) and facility privileging (when applicable) who performs a professional service within his/her scope of practice and independently reports that professional service.”
Currently our patients do not leave the hospital with a midline in place.
Can we charge for this service performed solely by a PICC team nurse?
Any insight would be greatly appreciated!
Thanks,
The American Medical Association (AMA) established a definition for a qualified healthcare professional (QHP), in terms of which providers may report medical services:
“A ‘physician or other qualified health care professional’ is an individual who is qualified by education, training, licensure/regulation (when applicable) and facility privileging (when applicable) who performs a professional service within his/her scope of practice and independently reports that professional service.”
Currently our patients do not leave the hospital with a midline in place.
Can we charge for this service performed solely by a PICC team nurse?
Any insight would be greatly appreciated!
Thanks,