Cardiology Question for the Week of May 14, 2018
MedLearn Publishing
May 14, 2018
Can you explain the steps involved in ligating and dividing the long saphenous vein and the code choices for this procedure?
Can you explain the steps involved in ligating and dividing the long saphenous vein and the code choices for this procedure?
We are looking for clarity about billing for immunosuppressive drugs. If a supplier mailed an immunosuppressive drug shortly before the end of a beneficiary’s inpatient stay and used the mailing date as the date of service, would the claim be rejected if this happened because the claim’s date of service preceded the beneficiary’s date of discharge?
Recoupment and one-day inpatient admission for total knee replacement. EDITOR’S NOTE: The following is a summary of a broadcast segment on Monitor Monday, May 7
HRSA claims delay will have no impact on current stakeholders. The Health Resources and Services Administration (HRSA), which administers Section 340B of the Public Health
Misinformation abounds in wake of execution of search warrants. The recent raid on President Trump attorney Michael Cohen’s office has brought much discussion about the
The scoring mechanisms of the MDM are suggested tools, not rules or laws. In our last article we explored how time in conjunction with medical
AHIMA hopes data gathering and sharing will help address the issue. Every day, more than 115 people in the United States die as a result
Physician documentation issues during an audit go beyond CDI. The issues are the chief complaint and HPI. Editor’s Note: This is the second piece in
CMS encourages providers to talk, test, and treat STDs. When it comes to sexually transmitted disease (STD) awareness, the Centers for Medicare & Medicaid Services
Expansion of new ICD-10 codes has slowed. The 2019 Inpatient Prospective Payment System proposed rule covers many Medicare Severity Diagnosis-Related Groups (MS-DRGs) changes, in addition
When a left heart catheterization is performed with coronary artery angiography but no left ventriculogram is performed, what is the proper coding?
I read the answer to your March 19 question, and I don’t believe the response from MedLearn completely answers the question posed by the writer. Specifically:
• The question did not mention anything about a patient being seen in different hospital departments.
• The response refers to the NCCI Policy Manual for Medicare Services, chapter XI, section B, item 4, indicating that the following guideline can be found there: “When the PICC is inserted/placed by the same department (cost center) then the IV Infusion/injection is considered a component of the procedure and not separately billable.” However, I do not see any reference in the NCCI manual guidance about the same department (cost center). For this chapter, go to file:///C:/Users/Tillie/AppData/Local/Temp/Temp1_NCCI-Policy-Manual-2018.zip/CHAP11-CPTcodes90000-99999_final%20103117.pdf.
My interpretation of the NCCI manual guidance, item 4 is as follows: It states that placement of peripheral vascular access devices is integral to IV infusion and injections and not separately reportable (e.g., 36000—introduction of needle/catheter into vein), 36410—venipuncture). This guidance is also documented in the CPT manual under the Vascular Injection Procedures section, which is referring to intravenous injection procedures into veins and arteries or catheters (e.g., peripheral IV access.)
However, per the NCCI guidance, if it is central venous access (e.g., CPT 36568, 36569), which is not routinely necessary to perform infusions/injections, this service MAY be reported separately. Central venous access procedures are different than vascular injection procedures.
So, if a PICC meets the description of a peripherally inserted central venous catheter (per the CPT manual) “to qualify as a central venous access catheter or device, the tip of the catheter/device must terminate in the subclavian, brachiocephalic (innominate) or iliac veins, the superior or inferior vena cava , or the right atrium” then when CPT codes for central venous access catheter procedures are reported with a CPT code for the IV infusion/injection administered on the same day, per the CPT manual and NCCI manual guidance and instruction it is appropriate to report it with the -59 or XU modifier regardless of the same department or revenue center.
I would appreciate your review of the initial question and my comments and any additional explanation or information you could provide on this issue.
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