IV start

[nikki_coder]

Hello. Can anyone tell me what the difference is between the CPT code 36000 and 36410. The company that i work for has always coded IV starts as 36410. Im wondering if we may be wrong.

Thanks

 

[Rncoder]

I code for an emergency room. and am also a nurse there too. I would use code 36000 to capture points for a routine iv start by staff supervised by an doctor. 36410 is when the doctor actually does the procedure him/herself and it is clearly stated that this code is not to be used for routine venipuncture. Be careful using the 36410 as it is age specific and if the doctor put in a central line, art line etc...that would be a different code too.

 

[Cottrell]

This is how my Coders's Desk Referecne describes the 2 procedures:

36000-the physician places a needle or catherter through a puncture in the skin and into a peripheral vein

36410-A needle is inserted through the skin to puncture a vein of a person 3 years of age or older. The needle is inserted into the vein and used for the withdrawal of blood for diagnotsic study or for the therapeutic infusion of intravenous medication. A soft flexible catheter may be placed for prolonged therapy. Once the procedure is complete, the needle or catherter is withdrawn and pressure is applied over the puncture site to control bleeding. Use this code for venipncture necessitating a physician's skill, not when routine venipuncture is performed.

 

[Cottrell]

IV start and hydration

If you are also doing the hydration you may want to look at codes 90760 &90761.These are used to "report the infusion fo prepacked fluids and electrolytes and NOT drugs for other substances".
The 36410 and the 36000 are included in these codes.

 

[nikki_coder]

Thanks for your help

 

[RCain62]

36000

I totally agree with Cottrell about using the codes for infusion that are now in the 963XX series and which are based on time. So my question is, if the time spent does not meet the time requirement for one of the 963XX codes, is it appropriate to code 36000 with the J code for the bag? Often times the doctor is just starting a line to keep the vein open for further treatment once the patient is transported to the ED.

Thanks in advance