Wiki PICC line placement under MAC

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lenora rodes

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When a CRNA (non medically directed) places a PICC line (includes MCS) with an Anesthesiologist providing MAC how should this be coded?

Should the line placement be coded (CPT36569)? The MAC (CPT 00532)?

Both providers have the same tax ID number so coding both is probably not appropriate.

If a reference could be cited with any reply it would be greatly appreciated!!

Thank you very much for your insight,

Lenora Rodes, CPC
 
Lenora,

Your coding is correct as long as this service is within the CRNAs scope of practice/state licensure. I also agree with the MDA code of 00532-G8 for the MAC. Below is from the CMS Provider Manual - Section 140.

140.4.3 - Payment for Medical or Surgical Services Furnished by CRNAs
(Rev. 1, 10-01-03)
B3-16003.H
Payment can be made for medical or surgical services furnished by nonmedically directed CRNAs if they are allowed to furnish these services under State law. These services may include the insertion of Swan Ganz catheters, central venous pressure lines, pain management, emergency intubation, and the pre-anesthetic examination and evaluation of a patient who does not undergo surgery. Payment is determined under the physician fee schedule on the basis of the national physician fee schedule conversion factor, the geographic adjustment factor, and the resource-based relative value units for the medical or surgical service.

http://www.cms.hhs.gov/manuals/downloads/clm104c12.pdf

Julie, CPC
 
Julie,

Thank you very much for the response and reference.

To clarify:

You would code both the line placement and the ASA code even though the providers have the same tax ID number?

I really appreciate your insights!!

Thank you,

Lenora
 
Lenora,

With the information you've provided I view these as two separate services - meaning the PICC line was NOT placed for anesthesia purposes. CRNA is surgeon and MDA is anesthesia provider. Yes, I would bill for both as long as I had apporpriate separate documentation from each provider.

Julie, CPC
 
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