Anesthesia Coding Alert

Question: What rules apply to reporting procedures with fluoroscopic guidance code 75998? Should I use it if our anesthesiologist uses fluoroscopic guidance while inserting a central venous line?

Texas Subscriber

Answer: Central line placement coding changed radically this year, thanks to all the CPT revisions.

Report add-on code +75998 (Fluoroscopic guidance for central venous access device placement, replacement [catheter only or complete], or removal [includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic supervision and interpretation, and radiographic documentation of final catheter position] [list separately in addition to code for primary procedure]) in addition to the line placement code (36555-36585). CPT's introductory guidelines include rules for correctly reporting add-on codes.

Remember that you need documentation of final catheter position before coding with 75998. The physician should include a note confirming his use of fluoroscopy to place the catheter, as well as information on the catheter's final position.