Anesthesia Coding Alert

Answer: You can code intravenous (IV) starts separately in certain situations, such as when the anesthesiologist is called to the nursing unit to help with a difficult stick.

 The correct code depends on the patient's age and the IV location. The most common code for venipuncture is 36410* (Venipuncture, child over age 3 or adult, necessitating physician's skill [separate procedure], for diagnostic or therapeutic purposes. Not to be used for routine venipuncture.). Other options are 36400 (Venipuncture, under age 3 years; femoral or jugular), 36405* ( scalp vein) and 36406 ( other vein).

 The current Medicare policy, which most carriers follow, says that venipuncture necessitating a physician's skill (36410) is defined as venipuncture on the veins of the neck, deep (central) veins of the thorax, or the groin. The physician must puncture the vein at the time of specimen collection and have sufficient documentation to support the need for a physician's skill. You must also include diagnosis codes 459.89 (Other specified circulatory system disorders) or V49.5 (Other problems of limbs) with all claims for 36410. If other diagnoses are reported or if you don't meet the documentation criteria for 36410, you'll be reimbursed at the rate for routine venipuncture (G0001, Routine venipuncture for collection of specimen[s]) instead.