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ladyanna119
PowerGlide MIDLINE charge

I would like to know what other hospitals are doing with regard to charging for the PowerGlide MIDLINE.  Right now we charge for the catheter and supplies, and then we have been placing it under a PICC line procedure charge.  This just seems like it's too much of a charge for a more simple procedure.  Has anyone built a new procedure charge for placing these? I agree that it is more than placing just a peripheral IV because it's sterile and ultrasound is used.  Apparently a Midline charge is billed the same as a PICC according to the AMA CPT? I asked our Bard Rep for some insight and he sent me the following:

Billing and Reimbursement

We cannot instruct a provider how to bill. We can only provide possible codes that may be

appropriate for the activities performed on a particular patient on a particular date of service

which are fully supported by detailed notes in the patient's medical record. The provider of

service must ascertain which codes are appropriate for the activities actually performed.

According to the American Medical Association CPT® Knowledge Base, “A midline catheter is

merely a shorter length peripherally inserted, central venous catheter. Code 36568, Insertion of

peripherally inserted central venous catheter (PICC), without subcutaneous port or pump; under

5 years of age, and 36569, Insertion of peripherally inserted central venous catheter (PICC),

without subcutaneous port or pump; age 5 years or older, for insertion of a peripherally inserted

central venous catheter (PICC) are reported for a midline PICC line. The specific code is selected

based on the specific age given in the code descriptor.”

 

Code Description

36568

Insertion of peripherally inserted central venous catheter (PICC) without subcutaneous port or

pump; under 5 years of age

36569

Insertion of peripherally inserted central venous catheter (PICC) without subcutaneous port or

pump; age 5 years or older.

mary-ivt
Billing for midlines

I went though this with our experts in coding and billing when the power glide first came to us.  It was decided that we can not bill them as PICCs.  They are not PICCs as they do not fit the description of a central catheter.  As Bard noted, they can not tell you what to do.  Our hospital experts decided to not risk the charge of fraud.  We bill only for the supplies (I think).  At any rate in time and money with a majority of our patients getting stuck more than 3 times during a hospitalization it is still a cost saver.  And an incredible patient satisfaction.

Mary Penn RN  VA-BC

Saint Charles MO

ladyanna119
Mary, are you able to just

Mary, are you able to just charge for the use of the ultrasound for the procedure? Thank you so much for your reply.  I appreciate the information!

Ann

 

 

Ann Armstrong, RN
PICC Lines
MidMichigan Medical Center, Midland

mary-ivt
Billing for midlines

I do not have an entry for charging for the use of an ultrasound.  It is capitatated into the PICC insertion charge.  I wish there was because I use ultrasound for starting a lot of IVs, especially in obese pts.

Mary Penn RN  VA-BC

 

Linda C. Smith
Billing for midiline

We are using the following codes

Midlines  C1751

Ultrasound 1st vessel  37250

Ultrasound 2nd vessel  37251

 

Hope this helps

Linda C. Smith, RN

tdinvamed
Reimbursement Codes for Power Midlines

Here are some possible, Reimbursement Codes for Power Midlines, depending on how you are unserting these;

 

Power Wand® and PowerStick® I

1. CPT or Q-Codes

36568: Placement of a catheter in subclavian or other vein, percutaneous, age 5 or under. (MST)

36569: Placement of a catheter in subclavian or other vein, percutaneous, over age 5. (MST)

 

Power Wand®, PowerStick® I, and PowerGlide

76937: Ultrasound insertion of a vascular access device with the aid of ultrasound (CPT/HCPCS) Note: requires “dynamic” technique: “...uses ultrasound during line placement. A recorded image of the procedure is required for coding.”

 

Power Wand®, PowerStick® I, and PowerGlide

2. HCPCS Code:

C1751 - Catheter, Infusion, Inserted Peripherally, Centrally or Midline (other than hemodialysis)

“Level II of the HCPCS is a standardized coding system that is used primarily to identify products, supplies, and services no

t included in the CPT codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when used outside a physician's office. Because Medicare and other insurers cover a variety of services, supplies, and equipment that are not identified by CPT codes, the level II HCPCS codes were established for submitting.

 

Hope this helps.

hlbrnmom
We use an E&M (evaluation &

We use an E&M (evaluation & management- visit code)- per our chargemaster people.

Code is a level 3.  111076

We also charge supplies. 

 

The only way you can charge for US guidance is if you "keep" photo record of it.  We don't keep it for Midlines- but do for PICCs.  So we are able to charge 707693704 with PICC starts as we print a vessel picture.

Heather Berndt RN, BSN, CEN, CRNI

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