Wiki Central Line Placement - supporting documentation

[Williealawishes]

Hello! If an one of our surgeons on call are asked to see an inpatient who needs a central line placed and I have supporting documentation of an H&P stating they talked with the patient and family, exam and decision was made with addtional documentation supporting the procedure. Can we bill this exam under guidelines with the appropriate modifier? I find all kinds of information on this supporting both sides. Mostly stating its ok to bill with critial care codes but I was wondering about inpatient codes.

 

[pkidd]

central line

Hi Tracy,

By "supportiing documentation for the procedure", do you mean that there is a handwritten or dictated procedure (op) note?

YES, you can bill the central line. Our practice is mostly successful being reimbursed for the procedure.

Be careful to append mod-25 to the e&m if there was a note that is separate from the procedure. Also be careful to check that another line had not been inserted or attempted by a hospitalist or other surgeon. If so, you'll need to append modifer 76 or 77.

EPIC: If your group/hospital is using EPIC, you will also need to check that Epic has not automatically billed the line.

Best of luck,
pat

 

[fwilliams]

Central Line Placement

Unfortunately, you can cannot bill for the service, only the placement. Remember, though your provider is on call, he is only referred to the patient for placement of the central line. The provider conducts H&P only because s/he is unfamiliar with patient. Modifiers -25 and -57, will not be applicable.

This is how my compliance auditor explained it to me and this is the guideline I currently follow. I hope this is helpful.