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