Friday, May 19, 2017

CPT code 36005, 36010, 36011, 33282, 33284

36005 Injection procedure for extremity venography 0.95 $328 $50

36010 Introduction of catheter, superior or inferior vena cava 2.18 $492 $114

36011 Selective catheter placement, venous system; first order branch 3.14 $842 $164

36012 Second order, or more selective, branch 3.51 $868 $181


Insertion 33282 Implantation of patient-activated cardiac event recorder Removal 33284 Removal of an implantable, patient-activated cardiac event recorder

CPT code 36005 (injection procedure for extremity venography (including introduction of needle or intracatheter)) should not be utilized to report venous catheterization unless it is for the purpose of an injection procedure for extremity venography. Some physicians have misused this code to report any type of venous catheterization.

Reimbursement and Billing Instructions

The procedure code for the implantation of the patient-activated event recorder – ILR is CPT code 33282.The code for the removal of this device is 33284. These procedure codes have a 90-day global postoperative care designation for which care related to the surgical procedure is not separately reimbursable unless such care is nonroutine, such as treatment of complications. Note that removal of a patient-activated event recorder – ILR on the same day as the insertion of a cardiac pacemaker is considered part of the pacemaker insertion procedure and is not reimbursed separately.

Table 9 illustrates billing instructions for each place of service:

* If the procedure is performed when the patient is an inpatient for a related problem, submit an institutional claim (UB-04 claim form or electronic equivalent) using a medically necessary diagnosis code.

* If the procedure is performed on an outpatient basis, submit an institutional claim (UB-04 claim form or electronic equivalent) using revenue code 360 and CPT code 33282 for implantation. The facility should bill for the device itself on a professional claim (CMS-1500 claim form or electronic equivalent) using HCPCS code E0616 with medically necessary primary diagnosis codes. Use CPT code 33284 with revenue code 360 to bill for removal of the device. Physician’s charges for the surgery should be billed by the physician on a professional claim.

* If the procedure is performed in a physician’s office, the physician should bill CPT code 33282 for implantation and E0616 for the device. Both codes are billed on a professional claim (CMS-1500 claim form or electronic equivalent). 

Type of Claim Institutional Institutional (and professional, if billing for device) Professional Revenue and

CPT Codes Revenue code 360

CPT code not needed Revenue code 360

CPT code 33282 for insertion

CPT code 33284 for removal Revenue code not applicable

CPT code 33282 for insertion

CPT code 33284 for removal

HCPCS Code Not needed On professional claim – E0616 On institutional claim – Not needed E0616

Note: Institutional claim formats include the UB-04 paper claim form, the 837I electronic transaction, and the institutional claim type on the Provider Healthcare Portal. Professional claim formats include the CMS-1500 paper claim form, the 837P electronic transaction, and the professional claim type on the Provider Healthcare Portal



Billing/Coding/Physician Documentation Information

This policy may apply to the following codes. Inclusion of a code in this section does not guarantee that it will be reimbursed. For further information on reimbursement guidelines, please see Administrative Policies on the Blue Cross Blue Shield of North Carolina web site at www.bcbsnc.com. They are listed in the Category Search on the Medical Policy search page.

Applicable codes: 93224, 93225, 93226, 93227, 93228, 93229, 93268, 93270, 93271, 93272, 33282, 33284, E0616,0295T, 0296T, 0297T, 0298T

BCBSNC may request medical records for determination of medical necessity. When medical records are requested, letters of support and/or explanation are often useful, but are not sufficient documentation unless all specific information needed to make a medical necessity determination is included.

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