Can anyone provide some insight to charging for Midlines. It seems like we are putting in more Midlines theses days and our coder has said we can not charge for a midline even tho we are using max barrier and ultrasound. He said the charge is getting denied. I have been told that its the same code as a PICC. It is what most are doing, using the same as code as a PICC?
At our facility we charge a midline the same as a PICC. The problem with this is if the patient receives a midline and then two days later the MD decides they need a PICC some insurance providers (Medicare) won't pay for both. I don't know all the details but as a vascular access team we have been instructed by our director to make sure the patient won't be needing a PICC if we place a midline.
Hope this helps
Jessica Newsom
Are you inserting into inpatients or outpatient? Inpatient for Medicare comes under the DRG. So there is no more money paid regardless of whether you are placing a PIV, midline, or picc. Every "charge" for the entire stay comes under this flat fee. There are other data collection reasons to code procedures but money paid to your facility is not one of them. Outpatient is different but I don't know the procedure code. I think most do use the same for both catheters. Also there are several types of codes.
I found a website for HCPCS codes but can't paste URL from tablet there are also CPT codes HCPCS Code is same for midline and picc Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861