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Pulmonology Coding Alert

READER QUESTIONS:

Include Central Line Placement Code on Critical Care Claim

Published on Wed Jan 28, 2009

Question: A 22-year-old motor-vehicle accident victim reports with multiple injuries, and the pulmonologist provides 85 minutes of care to this critically injured patient. During this time the physician uses ultrasound imaging to place a femoral line (nontunneled centrally inserted venous catheter). Is the line placement separately reportable, or is it part of the critical care package? Idaho Subscriber Answer: You should carve the line placement service out of the total critical care time, because it is a separately reportable service. CPT 2009's Critical Care Services introductory notes list several procedures that are included in 99291 -- such as chest x-rays (71010, 71015, 71020) and cardiac output studies (93561, 93562). Placement of a femoral line is not on this list. Example: Let's say it took the pulmonologist 15 of those 85 encounter minutes to place the line. On the claim, you would report the following: • 99291 (Critical care, evaluation and management [...]
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