ED Coding and Reimbursement Alert

Question: The operative report indicates that the physician performed a level-five evaluation and management service on a 2-month-old, then placed an intraosseous line in the patient for venous access. What code should I report for the line placement? Will the patient's age affect the code choice?

Indiana Subscriber
 
Answer: The young age of the patient will not affect your code choice; there is only one code for intraosseous line placement. On the claim:

- report 36680 (Placement of needle for intraosseous infusion) for the line placement.

- report 99285 (Emergency department visit for the evaluation and management of a patient, which requires these three key components: a comprehensive history; a comprehensive examination; and medical decision-making of  high complexity) for the E/M service.

- attach modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to 99285 to show that the E/M and the line placement were separate services.