Anesthesia Coding Alert

Question: A carrier recently began bundling brachial arterial lines with the primary procedure (such as coronary artery bypass graft [CABG] or open heart surgery[OHS]). This carrier has reimbursed us separately for the placement (we use 36120) for several years, and we don't have an agreement or contract that permits the bundling. What should I do?

Maine Subscriber
 
Answer: Your code selection might be the problem. You've reported 36120 (Introduction of needle or intracatheter; retrograde brachial artery) for vascular injection procedures in association with vascular catheter lab radiology studies, but the more appropriate code for an arterial line is 36620 (Arterial catheterization or cannulation for sampling, monitoring or transfusion [separate procedure]; percutaneous). You might also want to add modifier -59 (Distinct procedural service) to 36620 when the physician performs it in addition to the primary procedure. Check with your carrier to determine whether its coding guidelines for these procedures have changed.