Eric Posted Mon 29th of April, 2019 12:35:49 PM
We are an urgent care facility looking at doing ultrasound midline placements for an infectious disease company. We would be responsible for the placement only and then removal once at home treatment is completed (We have an experienced vascular access registered nurse). I have received conflicting information on how to bill Medicare for these procedures. I have been told to bill it as a PICC under 36573 with the modifier 52. I have also been told to bill it under 36410 and 76937 and that we may be able to bill for the sterile surgical supplies under HCPCS code(s). However, the reimbursement for CPT code group 36410 and 76937 seems a little low and someone mentioned the 36410 code was for specimen collection only?? What is the correct code to bill Medicare for midline placement and removal as an urgent care centerl? Thank you in advance.
SuperCoder Answered Tue 30th of April, 2019 03:06:02 AM
Thanks for your question.
Code 36410 is reported only for venipuncture performed by the physician when ancillary staff such as a phlebotomist, lab technician or nurse cannot obtain the specimen, or the patient has poor venous access. This is not the case here. So, you cannot report this.
Report code 36573 when the provider places a catheter under imaging guidance through the basilic or cephalic vein in the arm and directs it into one of the major veins carrying blood to the heart or directly into the right atrium, without placing a subcutaneous port or pump, in a patient five years of age or older. This code covers image documentation and all radiological supervision and interpretation required for the procedure.
If the provider performs 36573 but does not confirm the catheter tip’s location, then you should append modifier 52 (Reduced services) to this code.
Please feel free to write if you have any question.