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Outpatient FAQ October 2018

Published on 

Tuesday, October 2, 2018

 | RAC Information 
 | FAQ 

Q:

We have documentation that a PICC line nurse inserted a “PIV” in the patient’s right lower arm with a 20-gauge needle / angiocath. If the nurse had also documented the vein as the cephalic, basilic, or dorsalic, could we report this as a PICC line insertion, CPT code 36569?

A:

This sounds like a regular IV start that happened to be done by the PICC nurse.

Usually, if the PICC nurse puts in a true PICC line, they will specifically call it a PICC line. In your question, the PICC nurse calls it a PIV = peripheral IV, and they used a 20-gauge needle.

In order to report a PICC line, you would also need documentation of the final position of the catheter tip in a central vessel or right atrium – per CPT guidelines.

We usually see this documented by a chest x-ray or with a tip confirmation system like Sherlock.

Based on the details stated in the question, and assuming the PIV will be used for medications and/or IV fluids, there is not a CPT code to report.

It’s just an IV start - - even if it was difficult and required the skills of a PICC nurse.

Article Author: Jeffery Gordon, RN, MSN, CCA, COC
Jeffery Gordon, RN, MSN, CCA, COC, is the Manager of Outpatient Medical Review at Medical Management Plus, Inc. Jeff has over thirty-five years of experience in healthcare including Critical Care, Infection Control, Quality Assurance, Medical Necessity, Outpatient Coding, Medicare Claims data analysis and Medical Record review.

This material was compiled to share information.  MMP, Inc. is not offering legal advice. Every reasonable effort has been taken to ensure the information is accurate and useful.