Oncology & Hematology Coding Alert

Question: I'm seeing reports that our nurses perform a push of Heparin into a port, draw blood for the lab, flush the port with saline, and then push Heparin into the port again. Should I code these as pushes or a port flush?


Kansas Subscriber

Answer: Good question - you should code this as a port flush, not a push.

Key: The nurses are using Heparin, which is intended to unclog ports, not treat the patient. Many payers cover the cost of the Heparin, so check you policy to see if you can charge for this, too.

If this flush is the only service your nurses provide the patient on that service date, Medicare typically pays if you report G0363 (Irrigation of implanted venous access device for drug delivery systems [do not report G0363 if an injection or infusion is provided on the same day]). Some private payers follow suit, but others consider the service bundled into the overall treatment.

Another way: If a port flush is the only service performed on that service date, the AMA recommends coding 99211 (Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician. Usually, the presenting problem[s] are minimal. Typically, 5 minutes are spent performing or supervising these services).