I have been receiving conflicting information and hope to get a final true answer on here.
1. When a patient get lab thru their port, we use 36591 (blood collection VAD)and J1642 (heparin) and 96374 (IVPush for the heparin) along with the specific lab codes. We don't get the heparin reimbursed but are told we must include it to account for the IVpush code.
2. When a port maintenance only is done-no other charges.
We used to bill a 96523 but private insurances wouldn't recogonize the code. Only medicare paid it. We are being told to use 96374 (therapeutic, prophylactic or diagnostic IV push, single or initial substance) and J1642 for the heparin. They said that the 96374 is correct because the heparin is used prophylactically to maintain patency of the port. We still don't always get the heparin paid. Medicare only pays this way sometimes. We must bill all patients the same so what is the correct way to do this?
Thanks for your help!!
1. When a patient get lab thru their port, we use 36591 (blood collection VAD)and J1642 (heparin) and 96374 (IVPush for the heparin) along with the specific lab codes. We don't get the heparin reimbursed but are told we must include it to account for the IVpush code.
2. When a port maintenance only is done-no other charges.
We used to bill a 96523 but private insurances wouldn't recogonize the code. Only medicare paid it. We are being told to use 96374 (therapeutic, prophylactic or diagnostic IV push, single or initial substance) and J1642 for the heparin. They said that the 96374 is correct because the heparin is used prophylactically to maintain patency of the port. We still don't always get the heparin paid. Medicare only pays this way sometimes. We must bill all patients the same so what is the correct way to do this?Thanks for your help!!