Wiki General Surgery - I can bill a 36556 inserted non-tunneled

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MAIRA PATTERSON

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Hi
I will like to know if I can bill a 36556 inserted non-tunneled central venous catheter with a CPT Inpatient consultation 99251-99255 w/ 25 for hospital visits and a 57 modifier for the procedure. Do they need differents diagnosis?
Some people said yes and some people said no. Help :confused:
Your help will be greatly appreciated.

Thank you
Maira P. CPC
 
36556 has a zero-day global period. The correct modifier would be 25, which would be attached to the E&M service.
 
You would need to know if the physician was consulted ONLY for the line placement or for another reason plus the line placement. If the physician is consulted only for the line, you should not bill a consult code with cpt 36556. The minor consult or H&P obtained by the physician is considered included in 36556. If, however, the physician was asked to see the patient for another reason in addition to the line placement you could bill the consult w/modifier 25.
 
NO modifier on 36556

I agree with bran1120 .. if request for "consult" was specifically to place the CVL, NO consult should be billed (the E/M is bundled w/ the procedure).

If the request for consult was independent of the CVL, and, as a result of the evaluation of the patient your physician decided to perform the CVL, then you use a -25 modifier on the consult and NO modifier on the 36556. Your diagnosis may be the same.

F Tessa Bartels, CPC, CEMC
 
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To: FTessa,mdunn,bran1120,Treetoad
I really appreciate your feedback on this subject. Yes my physician was call to do a consult for a totally different reason and after doing the consult a decision to do a CVL was for a totally different reason.

Oh I forgot do you now how far back you can bill the patient for co-insurace, deductible and copay. I was looking for the guidelines and I could not find it. Please give some info on this.

Thank for all your help.
M.Patterson, CPC, RMM
 
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