Coding Chest X ray CPT code Post Central Line Placement

Basics-Chest X ray Post Central Line Placement

3 Scenarios to code Chest X ray Post Central Line Placement

We have already learned about the central line placement procedures. These procedures are commonly done for placing central venous catheters using temporary or permanent catheters. The code range varies for coding Tunneled and Non-Tunneled Central Venous Catheter (CVC) and Peripheral Central Venous Catheter (PICC) is from 36555-36571. In addition, we have to use guidance to place this central venous catheter in the exact position. Therefore, we know for taking access we are using ultrasound guidance (76937) code and for proper placement of catheter, we are using Fluoroscopic guidance (77001). Now, this is the short story about the central venous catheter along with the guidance codes. However, we are here to learn the complications of coding which start after placing the catheter. Here, we will discuss the procedure done after central line placement on same day or during global period.

Scenarios Chest X ray Post Central Line Placement

As we discussed above after correct placement of central venous catheter, the physician sometimes perform the chest x ray. This chest x ray post central line placement is mostly done to check whether the catheter is placed properly or not. Now here we will have three situations depending on the diagnosis.

Scenario -1.

Suppose the patient is having the same diagnosis as Central line placement, which is V58.81 (Z45.2) for central line placement (36555-36571) and for chest x ray (71045 or 71046) on same day. Now, here if we code chest X ray along with central line placement CPT Code, chest x ray may not be paid. The simple reason to explain is, chest X ray is normally done after central line placement to check the final position of catheter, and hence chest x ray exam is included with central line placement. So, please check the diagnosis before billing the chest x ray post-central line placement. The diagnosis should be either related or unrelated to original diagnosis but not the exact.

Scenario -2.

               

Now, for this we should first understand the concept of global period. Now, global period is nothing but the duration in which any procedure performed during the postoperative period related to the original procedure. The procedures performed during global period needs to be billed using global period modifiers like 78 or 79, to bill the extra services performed during global period.

Global Period for CPT codes

36555, 36556, 36558, 365690 days

36557, 36558, 36560, 36561, 36563, 36565, 36566, 3657110 days

Now, the CPT codes with 0 (zero) global period days will not have any benefit. So, the procedure performed during postoperative period will also be billed with these CPT codes without any modifiers. Perfect example will the that if after placing a central venous catheter, chest x ray is performed next day, this will also be billed with central line placement cpt code. But if the Chest x ray is done immediately after post central line placement it becomes a part of Central Line Placement procedure, which is not billed separately. Non-tunneled catheter (36555 &36556) and PICC placement without subcutaneous port or pump (36568 & 36569) do not have global period.

On the contrary, for CPT codes with 10-day global period will have different story. Now, here we will consider that there is some complication with central venous catheter placed during or after original procedure. So, if there is some complication present with central line placement and the patient comes in postoperative period or global period with related diagnosis, the services provided for the treatment will be billed using 78 modifier. So, if after placing central venous catheter the patient has a mechanical complication of central venous catheter having icd 9 code 996.1, and has to perform chest x ray, then the chest x ray cpt code will have 78 modifier like 71045-78. So, finally if any procedure performed during global period with diagnosis related to original procedure will be appended with 78 modifier.

Scenario -3.

Now, suppose a patient comes with unrelated diagnosis during the global period. Now, here also we have to use a modifier to bypass the CCI edits. For example, patient having a central venous catheter placement (V58.81) and has to undergo a chest x ray for pleural effusion (511.9) during global period. Since, these diagnosis are completely unrelated with each other in global period we will use 79 modifier with the chest x ray like 71045-79 to bypass the edits. So, if any procedure performed during global period with diagnosis unrelated to original procedure will be appended with 79 modifier.

Hope, these scenarios help you in coding Chest X ray CPT code Post Central Line Placement in future. Do share the article if you liked it.

9 Thoughts to “Coding Chest X ray CPT code Post Central Line Placement”

  1. […] catheter is V58.81. For vascular catheter placement, we always use V58.81 as primary diagnosis. A Central or Peripheral Central line placement procedures are always done to give antibiotics, to avoid frequent injection, for infusion etc., hence this icd […]

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  3. […] 77003 is used for non-vascular exam like spinal procedure and 77001 for vascular procedure like central line placement. For ultrasound guidance also we have separate codes for vascular and non-vascular percutaneous […]

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  5. x-ray Mandurah

    X-rays are really helpful in diagnosing some health problems and must be done regularly to make sure of your health.

  6. Sam Gibson

    Thanks for providing this information about chest X-rays. I would imagine that when it comes to getting an x-ray, you’d want to have it done with a quality machine. It also seems like healthcare professionals would want to purchase this type of equipment from a trusted professional who can also do repairs if needed.

  7. prostate mri Gold Coast

    Medical imaging refers to technologies used to view the human body in order to diagnose, monitor, or treat medical conditions.

  8. Gold Coast radiology

    the benifits of ultrasound are improved upon and cannot be replicated

  9. […] A central venous catheter, also called a central line, is a long, thin, flexible tube used to give medicines, fluids, nutrients, or blood products over a long period of time, usually several weeks or more. In this procedures, a catheter is often inserted in the arm or chest through the skin into a large vein. The catheter is threaded through this vein until it reaches a large vein near the heart. Their are separate procedure codes like CPT code 36569 used for coding central line catheter placement.  […]

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