Fee Navigator®

    Health Service Code 50.99C

    Venous access procedure

    1. May only be claimed:
      • for hospital inpatients under the age of 3 years.
      • where the procedure requires physician involvement due to a previously failed attempt or when suitable qualified personnel are unavailable.
    2. May be claimed in addition to a hospital visit or consultation.
    3. An unscheduled service modifier may not be claimed if a hospital visit or consultation is claimed.
    4. May not be claimed in addition to 16.81A or 50.98B.
    Category:M Minor Procedure
    Base rate:$81.81

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    LVPLVP75YesReduce Base To75%

    Governing Rules:

    • 6.1

      If a physician performs a minor procedure and provides a service warranting a claim for an office visit or a home visit on the same day, benefits for both may be claimed only if the services and diagnoses are unrelated.

    • 6.2

      If a service is provided in a hospital emergency department, AACC or UCC, only the minor procedure or the visit benefit, whichever is the greater, may be claimed, unless the problems are emergencies and the diagnoses are unrelated.

    • 6.7.1

      If a minor procedure (M or M+) is provided with a hospital visit on the same day, only the greater benefit HSC may be claimed.