# Crna billing for iv start



## 01096327 (Oct 16, 2009)

I work for a critical access hospital and have a question about the wasy our CRNA is billing, here is the scenario.  The patient was here for an OP CT of the Abdomen, the CT tech called the CRNA because several unsuccessful attempts were made to start the IV.  The CRNA billed a 36410.  I am under the impression that you don't bill a venipuncture code if no blood is drawn, which is the case in this situation.  The IV was started in the patients hand.  Would 36000 be more correct for them to bill in this situation?  I am new to anesthesia billing so any help on this would be great.

Thanks
Kathy


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## jdrueppel (Oct 16, 2009)

Kathy,

I use 36410 for hard start IVs (CRNA or MDA).  This began as a billing guideline from MC years ago and is also accepted by all of my other payers.

Julie, CPC


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## AYCPC (Oct 20, 2009)

I use 36410 as well. I am curious to the response of fellow coders as I never thought of it as not being a blood draw..However I can tell you from our CRNAs they do not make the best coders lol..


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## vworsham (Feb 18, 2010)

*IV start*

I use 36000 but am having problems getting it paid for an IP.  Most Ins will pay OP though. I thought of the 36410 was for Physcian only, not CRNA's.  what do you think??


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## AYCPC (Feb 22, 2010)

We use it for the Drs and CRNAs and have not encountered alot of problems (if any). I don't think there is anything about 36410 that makes it specific to docs. Does that help?


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## TammyW (May 6, 2010)

36410 specifically says in the CPT manual "necessitating physician's skill" ... 
When our CRNA's help out another department with IV starts, we do not bill.  There was no anesthesia skill that was required ... simply one department helping another that could not get the IV started.   More like customer service instead of penalizing the patient with another fee just because the first nurse or tech could not get the access.


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