Primary Care Coding Alert

Question: My office is not a surgery center, but we do perform minor surgeries under POS 11. My question is: can we bill for the intravenous (IV) services —the fluids, the tubing, and so on — separately?

Illinois Subscriber

Answer: Because you are performing the surgeries using place of service (POS) code 11 (Office), you are not billing a facility fee for your supplies. Consequently, you may be able to bill separately for some supplies if they are not considered a typical medical supply associated with the procedure (as captured in the practice expense relative value units associated with the procedure code) and are separately payable per payer guidelines.

That means, depending on the procedure, you can bill for the IV catheter, tubing, and dressing if you use them during the surgery. However, if you are billing for moderate or conscious sedation using 99151-99153 (Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports …), note that you cannot bill for the IV administration unless it is unrelated to the sedation service, as IV administration is considered a component of the moderate sedation service. If IV administration is unrelated to the sedation, you will need to unbundle them using a modifier such as modifier 59 (Distinct procedural service) if the documentation supports its use.