Wiki Port Placement with same day follow up Chest Xray

[jaldrich]

Can anyone please help me with a dilemma in my clinic?

Patient is in OR of the ASC to receive Portacath. CPTs billed are 77001 for Fluoro and 36561 for cath. Patient is then sent to recovery of the ASC. Once patient recovers, pt is sent to the radiology dept for a Chest 1 view (71010) to make sure there is not a pneumothorax. Patient does not exhibit signs of an issue, this is a standard procedure to get a Chest 1 view.
Medicare is saying the 71010 is bundled with the 77001 but COULD be unbundled.
Is it appropriate to bill the Chest 1 view with a modifier 59?
Thank you,

Jennifer

 

[JMAiken]

You can do it with a 59 mod and send notes. Just make sure your in your dx you show V58.81 so that they know you are checking the line that was put in.

 

[JADONATONI16]

I would not recommend billing separately. Per NCCI Manual:

32. When a central venous catheter is inserted, a chest radiologic examination is usually performed to confirm the position of the catheter and absence of pneumothorax. The chest radiologic examination is integral to the procedure, and a chest radiologic examination (e.g., CPT codes 71010, 71020) should not be reported separately.

 

[berryc]

I agree to not bill the chest xray per NCCI guidelines. Follow up chest is included in the line placement. You can find the guidelines at cms.gov.

 

[tmlbwells]

If the radiologist didn't do the procedure you can charge for the xray. If he did, then you can't.