Billing an E/M with Placement of a Central Line

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February 18, 2016

Question:
In a recent coding coach, you mentioned that an E/M would be inappropriate with placement of a central line. I’m not sure that is always the case. Can you clarify?

Answer:
Thank you for following up on this question. The Coding Coach specifically described a situation in which a surgeon responds to a specific request to place a central line with a port. Since that code includes 35 minutes of pre-service time, the time spent evaluating the access point, etc. is included in the procedure code. It might certainly be the case that you are evaluating a patient and as part of a more comprehensive evaluation, assessment, and plan, you decide the patient would benefit from a central line. In this case, if you have a medically necessary significant and separate E/M, you could report the E/M with a 25 modifier and the central line.

*This response is based on the best information available as of 02/18/16.