Post on 13-Aug-2020
Reimbursement and Category Codes for Ports
BARD ACCESS SYSTEMS: Required HCPCS Reimbursement Coding1
The following HCPCS codes represent services and procedures provided by physicians (CPT), patient conditions (ICD-9), and hospital inpatient descriptions (MS-DRG). These codes can be used as part of the reimbursement process required in the use of BARD ACCESS SYSTEMS products.
Procedure CPT Code Description
ICD-9 Procedure Code++
HOPPS Ambulatory Centers
Tunneled Venous Access
36557 Insert tunneled central venous catheter w/o port (<5yrs) N/A $1,708 $868
36558 Insert tunneled central venous catheter w/o port (>5yrs) N/A $1,708 $868
36565
Insertion of tunneled centrally inserted venous access device, requiring 2 catheters via 2 separate venous access sites; without subcutaneous port or pump (eg. Tesio type catheter)
N/A $2,052 $1,037
36581 Replace tunneled centrally inserted central venous access device w/o port 86.07 $1,708 $868
Port Procedures 36560 Insert tunneled centrally inserted central venous catheter
w/port (<5yrs) N/A $2,052 $1,037
36561 Insert tunneled centrally inserted central venous catheter w/port (>5yrs) N/A $2,052 $1,037
36582 Replace tunneled centrally inserted central venous catheter w/port 86.07 $2,052 $1,037
36570 Insert peripherally inserted central venous access device w/port (<5yrs) 86.07 $1,708 $883
36571 Insert peripherally inserted central venous access device w/port (>5yrs) N/A $1,708 $883
36585 Replace peripherally inserted central venous access device w/port 86.07 $1,708 $883
PICC Procedures
36568 Insert picc (<5yrs) N/A $753 $415
36569 Insert picc (>5yrs) N/A $753 $415
36584 Replace picc w/o port N/A $753 $415
Reimbursement and category codes for ports continued on reverse side
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++ Payment rates are Medicare national averages
Procedure CPT Code Description
ICD-9 Procedure Code++
HOPPS Ambulatory Centers
Repair / RemovalProcedures
36575 Repair of tunneled or non-tunneled central venous access device w/o port 86.09 $430 $298
36576 Venous access device w/port 86.09 $753 $442
36578 Replace, catheter only, non-tunneled centrally inserted central venous catheter w/port 86.09 $1,708 $868
36589 Removal tunneled central venous catheter w/o port 86.09 $430 $271
36590 Removal tunneled central venous catheter w/port 86.09 $753 $415
36596 Mech remov tunneled central venous catheter 86.09 $753 $447
36597 Reposition venous catheter under flouro N/A $753 $447
Guidance Procedures 76937 Ultrasound guidance for vascular access with permanent
recording 88.79 Packaged Packaged
77001 Flouroscopic guidance for central venous 87.39 Packaged Packaged
American Medical Association’s “Physician’s Current Procedural Terminology CPT© 2008”, www.ama-assn.org Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, and Other Part B Payment Policies for CY 2008; Revisions to the Payment Policies of Ambulance Services Under the Ambulance Fee Schedule for CY 2008; and the Amendment of the Federal Register / Vol. 72, No. 162 / Wednesday, August 22, 2007 / Rules and Regulations; Centers for Medicare & Medicaid Services, 42 CFR Parts 411, 412, 413, and 489, [CMS–1533–FC], RIN 0938–AO70; Medicare Program; Changes to the Hospital Inpatient Pros Federal Register / Vol. 72, No. 214 / Tuesday, November 6, 2007 / Rules and Regulations; Centers for Medicare & Medicaid Services, 42 CFR Parts 411, 412, 413, and 489, [CMS–1533–CN3], RIN 0938–A070; Medicare Program; Changes to the Hospital Inpatient Pros
C. R. Bard, Inc. does not guarantee that use of any of the codes noted above will ensure coverage or payment at any particular level. Medicare payment can vary in different sections of the country. Coding and payment can also vary for insurers other than Medicare. Physicians and hospitals should confirm with a particular payor or coding authority, such as the American Medical Association or medical specialty society, which codes or combinations of codes are appropriate for a particular procedure or combination procedures. Reimbursement for a product or procedure can vary depending upon the setting in which the product is used. Coverage and payment policies also change over time, so that information provided here may at some point need to be revised.
Reference: 1. Adapted from Internal Data: http://www.crbard.com/products/reimbursement. Accessed November, 2009
© 2010 C. R. Bard, Inc. All rights reserved. [MC-0512-01] [1002R]*Bard, the leaf shape, and “Veins for Life”, are trademarks and/or registered trademarks of C. R. Bard, Inc.
”CPT © 2009 American Medical Association. All Rights Reserved”
“CPT codes copyright 2009 American Medical Association. All Rights Reserved. CPT is a trademark of the AMA. No fee schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS Restrictions Apply to Government Use.”
OUTPATIENTMedicare Program: Changes to the Hospital Outpatient Prospective Payment System and CY 2010 Payment Rates; Changes to the Ambulatory Surgical Center Payment System and CY 2010 Payment Rates; DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services, 42 CFR Parts 410, 416, and 419; [CMS-1414-FC]; RIN 0938-AP41
ASCMedicare Program: Changes to the Hospital Outpatient Prospective Payment System and CY 2010 Payment Rates; Changes to the Ambulatory Surgical Center Payment System and CY 2010 Payment Rates; DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services, 42 CFR Parts 410, 416, and 419; [CMMS-1414-FC]; RIN 0938-AP41
PhysicianMedicare Program: Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2010, DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services, 42 CFR Parts 410,411,414,415,485, and 498 [CMS-1413-FC]; RINs 0938-AP40
InpatientMedicare Program: Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and Fiscal Year 2010 Rates; and Changes to the Long- Term Care Hospital Prospective Payment System and Rate Years 2010 and 2009 Rates, DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services; 42 CFR Parts 412, 413, 415, 485 and 489; [CMS- 1406-F and IFC; CMS- 1493-F; CMS- 1337-F]; RIN 0938-AP33; RIN 0398-AP39; RIN 0938-AP76
Reimbursement and category codes for ports continued