My insurance company gets a ton of requests for vein procedures, in the office setting and in interventional suites, everywhere. Many of our providers try to work the bill for a higher payment. My question for you all is this: cpt 36478 is seen often for endovenous ablation of greater or lesser saphenous veins, and they may be performed with separate sticks in two places on the same vein in the same session, often because of tortuosity in the vein precluding laser treatment to the entire vein in one stick. My providers are requesting additional code 36479 in order to report the second stick in the same vein, same session. They say it is because they have to open a second kit and they want payment for it. The descriptor in that code says that it is for a second VEIN in the same leg, same session. I believe that this is incorrect and they should be adding a modifier to the 36478 in order to report a larger procedure. What do you all think? Has anyone had this problem? Thanks! I will be finishing my COC training very soon!!
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Wiki varicose vein coding
- Thread starter icd9rn
- Start date
Samantha.Prince
Networker
You are correct. The add on code 36479 (second and subsequent veins) can not be billed in addition to the code for the first vein (36478) if only one vein was treated.
The medical documentation needs to state two or more veins were treated in order to bill the additional code.
I don't know what "kit" the provider is using but the payment for the kit or kits is included in the 36479 as it is integral to the service provided.
The medical documentation needs to state two or more veins were treated in order to bill the additional code.
I don't know what "kit" the provider is using but the payment for the kit or kits is included in the 36479 as it is integral to the service provided.