PICC line placement in Home Health- help with billing

  1. I am setting up a PICC program in the HHA I work at. Is there anyone out there that can help me figure out the billing/coding end of it?
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  2. Visit Crazynurse68 profile page

    About Crazynurse68

    Joined: Apr '05; Posts: 7

    2 Comments

  3. by   NRSKarenRN
    In order for your agency to bill insurance company directly for PICC insertion and care, agency must have signed contracts companies with PICC charges identified. Otherwise agency not eligible for reimbursement UNLESS individual contract done for each patient needing care.

    Most insurances want to bundle PICC line care with cost of drug supply these days. Different insurance companies use differing codes too.

    Example:

    Service / Billing code/ Contract rate
    Single Lumen / S5498 / $8
    More than one Lumen / S5501 / $8
    Implanted Port / S5502 / $4
    PICC Line Supplies / S5520 / $90 (used for placement)
    Midline Supplies /S5521 / $90 (used for placement)
    PICC Line Placement / S2255 / $170
    Midline Placement /S5523 / $135


    Hope this helps.
    Last edit by NRSKarenRN on Apr 21, '05
  4. by   renerian
    Always can count on you for awesome information! Thanks.

    renerian

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