Radiology Coding Alert

Seamlessly integrate these new codes with a few helpful tips.

While you may have been briefly made aware of the new influx of peripherally inserted central catheter (PICC) CPT® codes, putting them into practice is easier said than done. Properly preparing for this brand-new set of revisions and additions, which went into effect on January 1, is vital to submitting clean claims.

One way to get yourself fully caught up on this new set of codes, among others, is to remain on top of all current coding affairs. You can do this by reading current newsletters, using free available coding forums and multiple free websites that offer current coding news, and networking with other coders, explains Carol Hodge, CPC,  CDEO, CCC, CEMC, certified medical coder at St. Joseph’s Cardiology in Savannah, Georgia.

In addition to these new PICC codes, you should have a firm grip of their respective sets of guidelines, as well. Read on to learn how you can painlessly apply these new PICC guidelines in your radiology practice.

Follow These Handy Tips to Correctly Report 36572, 36573, 36584

“Two new CPT^® codes, 36572 and 36573, were created to describe PICC line procedures that bundle imaging guidance, image documentation, and all associated radiological supervision and interpretation,” says Cynthia A. Swanson, RN, CPC, CEMC, CHC, CPMA, senior manager of healthcare consulting for Seim Johnson in Omaha, Nebraska.

Take a closer look at new codes 36572 and 36573:

• 36572 — (Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the insertion; younger than 5 years of age)
• 36573 — (… age 5 years or older).

Code 36584 revision: CPT^® also revised PICC code 36584. The revised descriptor now reads, with emphasis added: Replacement, complete, of a peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, through same venous access, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the replacement.

As you can see, 36584’s descriptor now includes all imaging guidance, image documentation, and all associated radiological supervision and interpretation needed to perform the PICC replacement.

Tips: Through the guidelines and parenthetical notes, CPT^® identifies specific rules you should follow when reporting 36572, 36573, and 36584. Follow these tips to keep your PICC claims in tip-top shape:

• Tip 1: You should never report 71045 (Radiologic examination, chest; single view) through 71048 (… 4 or more views) to document the final catheter position on the same day of service as 36572, 36573, or 36584.
• Tip 2:  Since 36572, 36573, and 36584 include confirmation of the catheter tip location, the radiologist who reports image-guided PICC insertion cannot report the confirmation of the catheter tip location separately.
• Tip 3: If the radiologist performs a 36572, 36573, or 36584servicebut does not confirm the catheter tip’s location, then you should append modifier 52 (Reduced services) to the appropriate code.
• Tip 4: Never report 36572 or 36573 in conjunction with +76937 (Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent real time ultrasound visualization of vascular needle entry, with permanent recording and reporting (List separately in addition to code for primary procedure)) or +77001 (Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic supervision and interpretation, and radiographic documentation of final catheter position) (List separately in addition to code for primary procedure)).
• Tip 4: Never report 36584 in conjunction with +76937 or +77001.

Dig Into These 36568, 36569 Revisions

Don’t miss these PICC code descriptor revisions. (Additions are underlined for emphasis.)

• 36568 — (Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, without imaging guidance; younger than 5 years of age)
• 36569 — (… age 5 years or older).

As you can see by the descriptors, you should report 36568 or 36569 only when the radiologist performs PICC placement without imaging guidance.

Don’t miss: If the radiologist places PICCs by using “magnetic guidance or any other guidance modality that does not include imaging or image documentation,” then you should also report 36568 or 36569, per the CPT^® guidelines.

Also, you should never report 36568 or 36569 in conjunction with +76937 or +77001, according to CPT^® guidelines.