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picc placed by someone other than radiologist

Miriam Posted Thu 10th of October, 2013 18:32:26 PM

if a picc line is placed by a physician and a hour or more later the radiologist reads a post picc chest view, can the chest view be billed? To further the initial question, in the post picc view if there are diagnostic findings other than relating to the picc can it be billed?

SuperCoder Answered Thu 10th of October, 2013 22:39:16 PM

The most current information available from the National Correct Coding Initiative Coding Policy Manual for Medicare Services states:

When a central venous catheter is inserted, a chest radiologic examination is usually performed to confirm the position of the catheter and absence of pneumothorax. The chest radiologic examination is integral to the procedure, and a chest radiologic examination (e.g., CPT codes 71010, 71020) should not be reported separately.

Based on this instruction, review the following CPT codes:

Central venous catheter insertion (36555–36571, 36578–36585)
Fluoroscopic guidance (77001)
Regardless of whether fluoroscopy is performed during PICC line insertion, you may not charge for the initial chest imaging film that ensures correct placement as a separate line item with modifier -59 (distinct procedural service). This is a screening exam for placement and is not diagnostic.
Hospitals should build the cost of the imaging into the overall charge for the procedure to ensure they capture the use of resources and are submitting appropriate charges for future APC rate setting.

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