# Fluoro Ports



## michaelrcpc (Apr 21, 2010)

Does anyone bill placing a port under fluoro?  The from  doctor are: 36571, 75989/26 and 76000. i checked ncci and figured 76000 is bundled with 36571 and 76000 is bundled with 75989 i told this to my dr and she wanted me to apply mod 59.. i did, but still rejected.. does anyone know how to bill these together?


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## Jim Pawloski (Apr 21, 2010)

michaelrcpc said:


> Does anyone bill placing a port under fluoro?  The from  doctor are: 36571, 75989/26 and 76000. i checked ncci and figured 76000 is bundled with 36571 and 76000 is bundled with 75989 i told this to my dr and she wanted me to apply mod 59.. i did, but still rejected.. does anyone know how to bill these together?



If this is done in IR, try 77001.  That is what I use.
HTH,
Jim Pawloski, CIRCC


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## dpeoples (Apr 22, 2010)

michaelrcpc said:


> Does anyone bill placing a port under fluoro?  The from  doctor are: 36571, 75989/26 and 76000. i checked ncci and figured 76000 is bundled with 36571 and 76000 is bundled with 75989 i told this to my dr and she wanted me to apply mod 59.. i did, but still rejected.. does anyone know how to bill these together?



I agree with Jim, you should probably be billing 36571/77001. Without seeing the report I can't be more specific, but I wonder why the doc wants to bill 75989? that is usually for placement of an abscess drain.

HTH


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## michaelrcpc (Apr 22, 2010)

Thanks all, 

here is the procedure description from the op report:

....... one percent lidocaine with bicarb was used for local infiltration prior to all needle pokes and incisions. a right subclavian vein access was not successful and so a right internal jugular vein was easily accessed. guidewire was passed info the vein. this was confirmed to be in proper position under fluoroscopy. a small incision was made on the skin and then this tract was dilated and then a sheath was passed over the guidewire. the guidewire and dilator were then removed and the catherer for smart port was then passed through the sheath and the sheath was peeled away. a site was chosen on the check for the port placement. an incision was created. this was carried down to the fascia overlying the pectoralis muscles and a pocket was created for the port. the catheter was then tunneled under the skin in the subcutaneous space down to the pocket. its position, again, was confirmed to be in proper position under fluoroscopy, cut to an appropriate lenght and attached to the port. the port was then placed in the pocket and secured to the fascia with 2-0 Prolene sutures. the port and catheter were easily aspirated and flushed with injectable saline. hemostasis was controlled using Bovie cautery. subcutaneous tissue was reapproximated with 3-0 vicryl interrupted sutures. ........


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## dpeoples (Apr 23, 2010)

michaelrcpc said:


> Thanks all,
> 
> here is the procedure description from the op report:
> 
> ....... one percent lidocaine with bicarb was used for local infiltration prior to all needle pokes and incisions. a right subclavian vein access was not successful and so a right internal jugular vein was easily accessed. guidewire was passed info the vein. this was confirmed to be in proper position under fluoroscopy. a small incision was made on the skin and then this tract was dilated and then a sheath was passed over the guidewire. the guidewire and dilator were then removed and the catherer for smart port was then passed through the sheath and the sheath was peeled away. a site was chosen on the check for the port placement. an incision was created. this was carried down to the fascia overlying the pectoralis muscles and a pocket was created for the port. the catheter was then tunneled under the skin in the subcutaneous space down to the pocket. its position, again, was confirmed to be in proper position under fluoroscopy, cut to an appropriate lenght and attached to the port. the port was then placed in the pocket and secured to the fascia with 2-0 Prolene sutures. the port and catheter were easily aspirated and flushed with injectable saline. hemostasis was controlled using Bovie cautery. subcutaneous tissue was reapproximated with 3-0 vicryl interrupted sutures. ........





based on this report I would code thus:
36561/77001

it is not appropriate to code 76000,75989. Nor is it appropriate to code 36571 (that is for a peripherally, think extremity, inserted tunnelled cath) as the jugular placement  is considered central.

HTH


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