Central Line Placement and an E/M Code. Can I Bill Both?

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January 14, 2016

Question:
If another physician asks me to place a central line for their inpatient, can I also report an inpatient consultation or other E/M code with a 25 modifier?

Answer:
If you are responding to a specific request to place a central line, the pre- and post-service evaluation you perform in conjunction with the central line placement is most likely included in the value of the procedure. For example, 36561 (tunneled catheter with port) is valued for 35 minutes of pre-service time, 45 minutes of intra-service time and 15 minutes of post-service time.  An E/M addition would not be appropriate since evaluation of the patient is already in the 35 minute pre-service time.

*This response is based on the best information available as of 01/14/16.