ED Coding and Reimbursement Alert

Question: Would the removal of a subclavian Hickman catheter be included in the E/M level? The chart indicates a level three, but the ED physician did not place the catheter. The removal required a 2-cm incision, the catheter was removed without difficulty, and the closure was simple.

Cheryl Goodrich
Mountaineer Emergency Physicians
Morgantown, W.V.

Answer: Use the appropriate ED E/M code (99281-99285) to bill for the catheter removal because it is not a separately billable service. The E/M level would reflect the work of the ED staff in removing the catheter. In your particular case, the criteria for a level-three E/M have been met and it is the only billable option. The more difficult the removal, the higher the E/M code.