Q/A: Correctly report port flush
APCs Weekly Monitor, June 25, 2010
Want to receive articles like this one in your inbox? Subscribe to APCs Weekly Monitor!
Q: How can a hospital report a PICC line flush and dressing change when no infusion service is provided? Is a low-level clinic visit appropriate or should patients perform these services outside the hospital on their own? Noridian, our FI, doesn’t allow a clinic visit for these services because it believes patients can perform this service themselves.
A: You should report the code that most closely represents the service provided. CPT code 96523 (irrigation of implanted venous access device for drug delivery systems) for a port flush describes the service; you should report this code. The CPT parenthetical note states that this must be the only service provided on that date of service.
In the example provided, you should report 96523 rather than an E/M visit code because it most accurately describes the service provided and no other service was provided that day. Although this is the correct CPT code, the documentation also must reflect the medical necessity of the service and local coverage decisions may affect the coverage of the service.
Want to receive articles like this one in your inbox? Subscribe to APCs Weekly Monitor!
Related Products
-
Modifier -59 Case Studies: Clarify Common Coding Confusion
Modifier -59 is a perennial problem area for outpatient coders. It shouldn’t be viewed as a way to guarantee payment but...
-
Outpatient Bed Charge Capture: Billing for Common and Complex Cases
During this 90-minute audio conference, our expert speakers walk you through common and complex cases and explain compliant...
-
Billing No-Cost and Low-Cost Devices: Tips to Avoid the Audit Fast Track
During this 90-minute audio conference, our speakers will use a case study to demonstrate best practices to help you comply...
-
Spinal ICD-9 and CPT Coding
During this two-hour audio conference, our speakers will discuss common coding errors for spinal diagnoses and procedures...
-
Facility E/M Coding: Tune up your criteria
During this live two hour audioconference, speakers will explain how to tune-up facility assessment criteria and ensure...
Most Popular
- Articles
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- Identify potential Medicaid RAC target areas
- Topic: CMS, OESS post new security compliance review information, checklist
- HIPAA Q&A: Level of encryption needed for email
- Capturing all necessary codes for IUD insertion and removal can be challenging
- What does case-mix index mean to you?
- OB services: Coding inside and outside of the package
- QA:Coding multiple initial infusions
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- HIPAA Q&A: Level of encryption needed for email
- Q&A: Follow CMS' coding guidelines when using modifier -25
- Catch up on what's new with injections and infusions
- CMS has reformulated payments for some bilateral procedures
- New conflicts of interest create new challenges
- Q/A. One injection code or two?
- What does case-mix index mean to you?
- ED-to-inpatient transfers are flawed with safety gaps
- Searched