Line Placement: Earn Nearly $100 for PICC Line Insertion -- If the Right Person Delivers the Service

Check 3 factors to ensure your medical billing is accurate.

Anesthesia providers frequently place lines for patients, whether it’s together with surgery or for other reasons. The next time you code for a PICC (percutaneously inserted central catheter) line insertion, you must keep in mind these three important factors to make certain you choose appropriately. Read this expert medical billing and coding article and know what CPT codes apply.

Note the Patient’s Age

Most of the CPT codes are divided for line insertion/venous access by age. Look at descriptors for terms such as "under 5" and "age 5 years or older" to automatically narrow your choices. This structure holds true for your PICC line options:

• CPT code 36568 – (Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump; younger than 5 years of age)
• CPT code 36569 – (… age 5 years and older)

Confirm Who Inserted the Line

It’s fairly common for non-physicians, for instance nurses, to insert PICC lines.

Medical Billing Tip: You cannot bill for PICC line insertions by non-physicians in the facility setting -- however a CRNA (certified registered nurse anesthetist) is outside the "non-physician" category of registered nurses as well as physician assistants. In case a CRNA or anesthesiologist places the PICC, you can report the service; in case an RN or PA inserts the line, on the other hand, you can’t bill the service.

Flat fee: The insertion of arterial lines and PICC lines are outside of the normal anesthesia services.There aren’t any time or base units linked with these procedures as they’re considered to be surgical procedures as an alternative of anesthesia/monitoring.

Determine Whether the Provider Used Guidance

"Blind" sticks were standard for years, however more providers use ultrasound guidance for PICC line placements these days. In case your provider uses ultrasound guidance, report CPT code +76937 (Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent real time ultrasound visualization of vascular needle entry, with permanent recording and reporting [List separately in addition to code for primary procedure]).

Medical Billing' Tip: In case your anesthesia practitioner doesn’t own the equipment or if he performs the procedure in a hospital, keep in mind to append modifier 26 (Professional component) to CPT code ' 76937. Or else, you may face denials, particularly from Medicare.