Radiology Coding Alert

Question: How do I code for a peripherally inserted central venous catheter (PICC) line placement with fluoroscopic guidance for a 75-year-old patient with a bladder infection? The patient is undergoing antibiotic therapy for the next six weeks. May I still bill if the line placement is unsuccessful?

Arizona Subscriber

Answer: To code for the insertion of a PICC, you should report code 36569 (Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump; age 5 years or older) since the patient is above 5 years of age. You may also code separately for the fluoroscopic guidance using code +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]).

Additionally, if the placement attempt is unsuccessful, you may still bill out using code 36569 along with modifier 52 (Reduced Services) attached. However, you should not bill out for +77001 with a modifier 52 for a discontinued procedure involving fluoroscopy.