tci Outpatient Facility Coding Alert - 2013 Issue 11

Reader Question: Consider A4300 or A4301 if Payer Prefers HCPCS Codes

Question: Is there a HCPCS code to correlate with CPT® code 36556? Our payer denies the claim when the anesthesiologist places the line on the same day of surgery. They say we need to submit a HCPCS code instead. What’s the best option? Wyoming Subscriber Answer: Most payers agree that anesthesiologists can report -- and be reimbursed for — central line placement (along with arterial line and Swan-Ganz catheter placements) in addition to the surgical anesthesia. If the payer in question takes that stance, you can usually report 36555 (Insertion of non-tunneled centrally inserted central venous catheter; younger...

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