# HELP!! CXR after PICC placement by PICC team



## pmogel (Mar 2, 2012)

Looking for clarification on this situation: The PICC team places the PICC. Our radiologist does the CXR after to confirm tip placment. Can we bill the CXR? 

Thanks for any thoughts!


----------



## TMBOYD (Mar 2, 2012)

No.  Chest x-rays following CVC placement, replacement, revision, or removal is considered part of the procedure and is not separately billable.  The scrubber software will also catch it and send back an edit, and if that does not happen the insurance company will deny the claim for that reason.

Reference  Dr Z.Interventional Radiology Coding Reference 2011. page 163.


----------



## jmcpolin (Mar 2, 2012)

What about when one physician under different tax id places the picc and then a radiologist different tax id reads the xray to see if it is placed correctly?


----------



## TMBOYD (Mar 2, 2012)

It is still considered part of the procedure if the chest x-ray is ordered just to check the picc placement.

I have seen a chest x-ray order for pneumonia on the same day as placement and billed with a 59 modifier.  It hit lots of edits before it even got billed and then the insurance  automatically denied it. Appeals and documentation to the insurance has proved to be time consuming and a very little return for the amount of effort.  If you decide to bill the x-ray please keep us informed of the results.  All insurances are different - you might find that one that will pay for both.

TMBOYD, CPC


----------



## pmogel (Mar 2, 2012)

Thanks for the input! I will keep you informed!


----------



## RADCODER (Mar 5, 2012)

I have been wondering the same thing, how about post thoracentesis (r/o pneumothorax)? I believe it is inclusive to the procedure, any thoughts/documentation?

Thank you.


----------

