Anesthesia Coding Alert

Question: Does HCPCS codes have a code to correspond to CPT 36556 ? Our carrier denies the code when the anesthesiologist places the line on the same day as surgery. It says we must submit a HCPCS code instead. 

Hawaii Subscriber Answer: Most carriers agree that anesthesiologists can report -- and be reimbursed for -- central line placement (along with arterial line and Swan-Ganz catheter placements) in addition to the surgical anesthesia. If your carrier takes that stance, you can usually report 36555 (Insertion of non-tunneled centrally inserted central venous catheter; younger than 5 years of age) or 36556 (... age 5 years or older) for central lines (CVPs).

If your carrier insists on HCPCS codes for line placements, consider A4300 (Implantable access catheter [e.g., venous, arterial, epidural subarachnoid, or peritoneal, etc.] external access) or A4301 (Implantable access total catheter, port/reservoir [e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.]). Before submitting your claim, check the carrier's guidelines to verify that using A4300 or A4301 is correct.

Contract reminder: A few carriers believe that the base units for anesthesia procedures include line placements, which means they won't separately reimburse the service. Remember line insertions when you negotiate carrier contracts and include Swan-Ganz, central and arterial line placements as payable services.