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Betsy Harmon
charge codes for PICC placement with ultrasound needed

Any an all help would be appreciated.  We have been billing for PICC insertion and Ultrasound and were apprently getting paid.  The corporate Radiology Director has indicated to my director  that you cannot bill for RN PICC insertion or use of Ultrasound.  I am looking for the procedure codes, charge codes, CPT codes or whatever they are called to provide my new director with.  Also any documentation support that is within the last couple of years would help.  I found out that we are basically having all the charge codes for all our PICC's backed out of the computer at the billing end because of Corporate direction and there is no billing for PICC's, supplies, procedure, ultrasound usage.  Thanks in advance. 

It depends on payment structure

First off there is no professional billing for labor by Medicare or Medicaid for a non professional.  (NP, CNS, MD, CRNA and a PA under an MD may all bill professional if they qualify)

Having said that it is good to keep productivity numbers so that the labor cost may come back to the department from the DRG

Medicare, Medicaid and some insurers are DRG based meaning they pay a flat rate for the diagnosis so RN labor is part of that DRG but professional billing is separate from  the DRG for labor.

Supplies on the other hand are not reimbursed for any discipline if it is part of a DRG regardless of who places it for Medicare and Medicaid and some insurers who recognize a DRG based system.  Having said that the department must get back the cost to the department from the DRG for the supplies so you should capture those internal codes (CPT) to get you materials back to your department internally.

You have to understand your insurers to determine if supplies are paid for separate or are DRG.  You can bill for supplies as the hospital used those supplies.  Supplies are not part of professionl llabor.  It still does not mean you get paid for them as they may be part of the all inclusive rate




Random VAT person

Here are the codes we use for RN placed PICC:

 The codes are what we use for RN placed PICC

+76937 – ultrasound guidance for vascular access

36569 – Peripherally inserted  Without subcutaneous port/pump  Age 5 and older

Plus we bill for procedure room time.

If you look up the 36569 code in a CPT book you will find related codes if you place lines in under 5 yr olds.

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