Understand status indicators for codes 36591 and 36592
APCs Weekly Monitor, January 25, 2008
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QUESTION: We have a question regarding CPT codes 36591 and 36592 for collection of blood from an implantable device. When we report these codes, our coding software provides a message that states "CPT codes 36591 and 35592 (collection of blood specimen from VAD or venous catheter) should not be reported in conjunction with any other service." The software also references the 2008 CPT Manual, stating that we should not report these CPT codes together in conjunction with any other service. Is this correct?
ANSWER: There is no direct information regarding whether you can report these codes with another service. With that said, each of these codes has the following status indicators: code 36591 (status indicator Q) and code 36592 (status indicator N.)
Status indicator Q means that code 36591 is packaged when there is another APC group on the claim with STVX. For example, when a physician draws blood from a port and performs chemotherapy on the same day, code 36591 (that you can separately identify with a charge) is packaged into the overall chemotherapy service due to grouping logic and 2008 payment policies. Consider the following other example: A physician draws blood from a port, and you only report the laboratory work (which has a status indicator A) on the claim. In this scenario, Medicare will pay for code 36591 and the laboratory work.
Code 36592 (blood from a Peripherally inserted central catheter [PICC] line) has a status indicator N, which means that if the physician performs these services with any other service on the same day (and charges those services), CMS will package them.
Version 14.0 of the NCCI does not contain any edits for codes 36591 or 36592.
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