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Port placement with same day follow up xray

Kathy k Posted Fri 01st of February, 2019 11:52:46 AM
If a surgeon did a mediport placement and the radiologist provided the fluoroscopy guidance as well as the follow up xray to confirm placement, can the radiologist bill for both the fluoroscopy 77001 and the xray 71045?
SuperCoder Answered Mon 04th of February, 2019 09:16:24 AM

Hi,

Our team is working on your query and will get back soon.

Thanks

SuperCoder Answered Tue 05th of February, 2019 02:40:17 AM

Hi,

As per 2019 NCCI edits, 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 71045, 71046) shall not be reported separately. So, the radiologist will only bill for fluoroscopy (77001).

 

Thanks

Kathy k Posted Thu 07th of February, 2019 11:54:35 AM
When looking at the 2019 CPT book specific codes are mentioned, it states "Codes 71045, 71046, 71047, 71048 should not be reported for the purpose of documenting the final catheter position on the same day of a service as 36572, 36573, 36584. Codes 36572, 36573,36584 include confirmation of catheter tip location." However, if a surgeon uses codes 36556-36566, could the radiologist code for the xray?
SuperCoder Answered Fri 08th of February, 2019 07:43:52 AM

Hi,

As per CMS NCCI guidelines, when a central venous catheter is inserted, chest radiologic examination will not be reported separately. if a surgeon uses codes 36556-36566, chest X-rays will not billed separately as this is consider integral part of procedure.

 

Please check below link:

https://www.cms.gov/medicare/coding/nationalcorrectcodinited/index.html

Click on : NCCI Policy Manual for Medicare Services – Effective January 1, 2019 [ZIP, 1MB

Open Chapter 5- CPT codes 30000-39999_final103118

Read page 22 and point 37

 

Thanks

Kathy k Posted Fri 08th of February, 2019 10:24:25 AM
Thank you
SuperCoder Answered Mon 11th of February, 2019 00:29:15 AM

Thank you, happy to help.

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