Wiki CT Contrast via Port billable?

[mgerlach321]

For many of our oncology patients that need CT scans our nurses are accessing and flushing ports prior to CT. Is this billable? Would you bill the 96523 - irrigation of implanted venous access device for drug delivery system and J1642 (heparin flush)?

 

[thomas7331]

Just my thoughts here, and I don't have a source to cite, but since the infusion of contrast is incidental to the CT, and a port flush is in turn incidental to any infusions, I think that if the only reason for the flush is to prepare the line before or after the administration of the contrast, then it should not be charged. But if there is a medically necessary reason (and a physician order) for the flush that is unrelated to the CT, then I think it would be appropriate to charge for it.

 

[trarut]

Port flush bundles with any other service performed on the same day. It's a Column 2 code in CCI. Consider it one of the "costs of doing business". As Thomas says above, it would have to be documented that the flush was performed for a reason completely independent of the CT scan being done and even with documentation, it would be incredibly difficult to get a payer to override a CCI "never" bundling edit.