Cardiology Coding Alert
36000 and 76000
Florida Subscriber
Answer: Even though 36000 (introduction of needle or intracatheter, vein) and 76000 (fluoroscopy [separate procedure], up to one hour physician time, other than 71023 or 71034 [e.g., cardiac fluoroscopy]) are not explicitly bundled with 93650 (intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement) in the Correct Coding Initiative (CCI), this does not mean they may be billed together. The introduction in the manual specifically addresses 36000 in this regard: A majority of invasive procedures require the availability of vascular and/or airway access; accordingly, the work associated with obtaining this access is included in the preprocedure services. Intravenous access, intra-arterial access, airway access (e.g., HCPCS/CPT codes 36000, 36140, 36400, 36410) are frequently necessary; therefore, CPT codes describing these services may not be separately reported when performed in conjunction with a more comprehensive procedure [such as 93650].
Although the manual does not directly address 76000, section one of the introduction discusses separate procedures by stating, When a related procedure is performed, a code with the designation of separate procedure may not be reported with the primary procedure. This is true even if the edit does not appear in the CCI. Whereas 76000 is designated as a separate procedure and is related to the primary procedure (i.e., the ablation), it should not be billed separately as well.
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