# 77001 Acceptable Primary Codes



## tchyko (Oct 31, 2008)

I bill for a radiologist and we removed a central venous catheter using flouroscopic guidance.  We submitted codes 36589 and 77001/26 to Medicare.  The 36589 was paid but the 77001/26 denied as "primary procedure not billed."  The description of 77001 is Fluoroscopic guidance for central venous access device placement, replacement, or removal.  I contacted the carrier and they state that the 36589 is not an acceptable primary code per CMS.  I asked for guidance in locating a policy and have been unsuccessful.  Does anyone know what the acceptable primary procedure codes for CMS are and where I can find this information?  Has anyone else experienced this with their Medicare contractor?  There is a discrepancy between the code description and the policy.  Thanks for help.


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## mbort (Oct 31, 2008)

here is the list:
Primary Px - 77001 




This list shows the primary procedure codes(s) appropriate for use with this add-on code.   


 Instructions  
  References  
  Primary Px  




36555  Insertion of non-tunneled centrally inserted central venous catheter; younger than 5 years of age  
36556  Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older  
36557  Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; younger than 5 years of age  
36558  Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or older  
36560  Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; younger than 5 years of age  
36561  Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older  
36563  Insertion of tunneled centrally inserted central venous access device with subcutaneous pump  
36565  Insertion of tunneled centrally inserted central venous access device, requiring two catheters via two separate venous access sites; without subcutaneous port or pump (eg, Tesio type catheter)  
36566  Insertion of tunneled centrally inserted central venous access device, requiring two catheters via two separate venous access sites; with subcutaneous port(s)  
36568  Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump; younger than 5 years of age  
36569  Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump; age 5 years or older  
36570  Insertion of peripherally inserted central venous access device, with subcutaneous port; younger than 5 years of age  
36571  Insertion of peripherally inserted central venous access device, with subcutaneous port; age 5 years or older  
36575  Repair of tunneled or non-tunneled central venous access catheter, without subcutaneous port or pump, central or peripheral insertion site  
36576  Repair of central venous access device, with subcutaneous port or pump, central or peripheral insertion site  
36578  Replacement, catheter only, of central venous access device, with subcutaneous port or pump, central or peripheral insertion site  
36580  Replacement, complete, of a non-tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access  
36581  Replacement, complete, of a tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access  
36582  Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous port, through same venous access  
36583  Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous pump, through same venous access  
36584  Replacement, complete, of a peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, through same venous access  
36585  Replacement, complete, of a peripherally inserted central venous access device, with subcutaneous port, through same venous access  
36589  Removal of tunneled central venous catheter, without subcutaneous port or pump  
36590  Removal of tunneled central venous access device, with subcutaneous port or pump, central or peripheral insertion  
36595  Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access  
36596  Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen  
36597  Repositioning of previously placed central venous catheter under fluoroscopic guidance


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## mbort (Oct 31, 2008)

tchyko said:


> I bill for a radiologist and we removed a central venous catheter using flouroscopic guidance.  We submitted codes 36589 and 77001/26 to Medicare.  The 36589 was paid but the 77001/26 denied as "primary procedure not billed."  The description of 77001 is Fluoroscopic guidance for central venous access device placement, replacement, or removal.  I contacted the carrier and they state that the 36589 is not an acceptable primary code per CMS.  I asked for guidance in locating a policy and have been unsuccessful.  Does anyone know what the acceptable primary procedure codes for CMS are and where I can find this information?  Has anyone else experienced this with their Medicare contractor?  There is a discrepancy between the code description and the policy.  Thanks for help.




I posted the list for you, your code is on it..not sure why they would deny it. It doesnt make sense to me. (The list is from Encoder Pro)


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## lavanyamohan (Nov 1, 2008)

tchyko said:


> I bill for a radiologist and we removed a central venous catheter using flouroscopic guidance.  We submitted codes 36589 and 77001/26 to Medicare.  The 36589 was paid but the 77001/26 denied as "primary procedure not billed."  The description of 77001 is Fluoroscopic guidance for central venous access device placement, replacement, or removal.  I contacted the carrier and they state that the 36589 is not an acceptable primary code per CMS.  I asked for guidance in locating a policy and have been unsuccessful.  Does anyone know what the acceptable primary procedure codes for CMS are and where I can find this information?  Has anyone else experienced this with their Medicare contractor?  There is a discrepancy between the code description and the policy.  Thanks for help.



Hi,
The documentation requirements are the criterion I suppose. The doctor must dictate a separate (outside the body of her operative note) interpretation of the fluoroscopic guidance and he/she must also have a permanent recording of the procedure documenting catheter position. If the doctor meets these requirements, he/she may report CPT code 77001-26 for the professional interpretation.


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## kevbshields (Nov 2, 2008)

What's the source for this "separate report" business on fluoro interps?

With services such as these, it should suffice for the provider to place his/her interp and notation of permanent images inside the body of the same procedure note.  It is not a standard practice for providers to separate these things into two and three distinct notes.  There is also no benfit from that practice--as it would certainly clutter up the medical record!

I'd like to gander at this source, because I just do not believe CMS had that sentiment in mind (creating separate reports for each CPT reported).  Come on!


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## Gloriaponti1 (Jul 29, 2020)

mbort said:


> here is the list:
> Primary Px - 77001
> 
> 
> ...


Thank you! I was questioning this because CPT states to use 76000 with CPT 36597, however we normally use +77001-26. This was exactly what I was looking for.


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## SharonCollachi (Jul 29, 2020)

Gloriaponti1 said:


> Thank you! I was questioning this because CPT states to use 76000 with CPT 36597, however we normally use +77001-26. This was exactly what I was looking for.




Well, that post is from TWELVE years ago, you might want to double-check things.


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