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Rad just providing guidance - demonstrates catheter

  1. Default Rad just providing guidance - demonstrates catheter
    Medical Coding Books
    Hi,

    My Rad is just providing guidance for the nursing staff during a PICC placement. They have been billing 96937 for the Rad but this is an add-on code. Is this correct in this scenario? If not, how should it be billed? Here's report.

    ACCESSION: (10286628,10287366)
    RN PICC PLACEMENT 36569
    RN PICC US GUIDANCE 76937

    RESULT: Indication: Left knee wound infection.

    Under aseptic precautions and with 1% lidocaine as local anesthesia, a 4 French 48 cm PICC line was placed into the right basilic vein by nursing staff. Ultrasound guidance was utilized and an image saved on PACS.

    Spot film of the chest demonstrates catheter tip of the PICC line is noted in the distal SVC location in satisfactory position.

    IMPRESSION: Successful PICC line placement by nursing staff under sonographic guidance

  2. #2
    Location
    Salt Lake City
    Posts
    841
    Default
    the radiologist would not be able to bill the 76937 by itself, did he read the chest xray post PICC line placement?
    Jenifer McPolin CPC, CPMA, RCC

  3. Default
    Yes, he reads the xray. Can he not get anything for providing the guidance?

  4. #4
    Location
    Salt Lake City
    Posts
    841
    Default
    The problem is that code is an add on code when the rad uses fluoro guidance you can bill 76000-26, but he can bill for the spot film 71010-26, and in order to bill the 76937-26 even with the 36569 there would need to be documentation of "patency of the vein", so I would say your doc could only bill for the chest xray
    Jenifer McPolin CPC, CPMA, RCC

  5. #5
    Default
    Quote Originally Posted by jmcpolin View Post
    The problem is that code is an add on code when the rad uses fluoro guidance you can bill 76000-26, but he can bill for the spot film 71010-26, and in order to bill the 76937-26 even with the 36569 there would need to be documentation of "patency of the vein", so I would say your doc could only bill for the chest xray
    According to Dr. Z, the chest x-ray is part of the Picc line insertion. U/S vascular guidance has to be described in the report and an hard copy image has to be placed in the chart, or in a PACS system.
    HTH,
    Jim Pawloski, CIRCC

  6. #6
    Location
    Salt Lake City
    Posts
    841
    Default
    Even if the radiologist did not place the PICC line? Is the nurse in the Rads office?
    Jenifer McPolin CPC, CPMA, RCC

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