Do and Don’t – CPT Code tunneled catheter exchange

CPT Code tunneled catheter exchange Intro

Insertion of a tube beneath the skin into the blood vessels to provide medication or nutrients to patients directly into the blood stream is termed as central venous access catheters (CVAC). The catheters are divided into temporary and permanent catheters. The temporary catheters are non-tunneled and permanent catheters are tunneled catheter. The tunneled catheters are generally placed for long duration. So, to keep the process in flow physicians have to keep checking the catheter. If there is any dysfunction with the catheters we have to exchange the tunneled catheter. Here, the procedure or CPT Code tunneled catheter exchange comes into picture. The exchange of tunneled catheter is coded only when there is any complication with the placed catheter. These procedures are very important for Clearing Certified Professional coder exams in first attempt.Let check out more about CPT code tunneled catheter exchange.
 
Do and Don't - CPT Code tunneled catheter exchange
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CPT Code tunneled catheter exchange or Replacement in details

Cpt Code tunneled catheter exchange or replacement is done either through same access site or different access site. The range of CPT Code tunneled catheter exchange is 36581-36585. The CPT code for non-tunneled catheter exchange is 36580. So, if there is replacement or exchange of non-tunneled catheter through the same site only one CPT code is coded 36580. See the details below about the CPT code tunneled catheter placement and replacement.
PICC Placement  Procedures
36568 Insertion peripherally inserted CVC w/o port, < 5 yrs old
36569 Insertion peripherally inserted CVC w/o port 5 yrs or older 
36584 Replacement: Complete of peripherally inserted CVC w/o subcutaneous port or pump, through same venous access 
36560 Insertion tunneled centrally inserted central venous access device (CVAD) w/subcutaneous port, < 5 yrs old 
36561 Insertion tunneled centrally inserted CVAD with subcutaneous port, 5 yrs or older 
36582 Replacement: Complete of a tunneled centrally inserted CVAD w/subcutaneous port through same venous access site
Tunneled Venous Access Procedures
36557 Insertion tunneled centrally inserted CVC w/o reservoir, < 5 yrs old
36558 Insertion tunneled centrally inserted CVC, w/o reservoir, 5 yrs or older
36581 Replacement: Complete, tunneled centrally inserted CVC w/o subcutaneous port or pump, through same venous access site 
36563 Insertion tunneled centrally inserted venous access device w/subcutaneous pump
36565 Insertion tunneled centrally inserted central venous access device, requiring 2 catheters via two separate venous access sites, w/o subcutaneous port or pump 
36566 Insertion tunneled centrally inserted venous access device, requiring 2 catheters via two separate venous access sites, w/subcutaneous port(s)
36583 Replacement, complete of tunneled centrally inserted central venous access device w/subcutaneous pump through same venous access 
Non-Tunneled Venous Access Procedures
36555 Insertion non-tunneled centrally inserted central venous catheter (CVC), < 5 yrs old
36556 Insertion non-tunneled centrally inserted CVC 5 yrs or older 
36580 Replacement: Complete of non-tunneled, centrally inserted CVC w/o subcutaneous port or pump, through same venous access site
36570 Insertion peripherally inserted CVAD w/port < 5yrs 
36571 Insertion peripherally inserted CVAD w/port 5yrs or >
36585 Replacement: Complete peripherally inserted CVAD w/subcutaneous port through same venous access site
Repair, Removal, Partial Replacement Procedures
36575 Repair tunneled or non-tunneled central venous catheter w/o subcutaneous port or pump, central or peripheral insertion
36576 Repair central venous access device w/subcutaneous port or pump, central or peripheral insertion sites
36578 Replacement: Catheter only, central venous access device w/subcutaneous port or pump, central or peripheral insertion site
List of ICD 10 codes used for above procedures

T82.390A

T82.391A

T82.392A

T82.49XA

T82.590A

T82.591A

T82.593A

T82.595A

T82.598A

T82.7XXA

T82.818A

T82.828A

T82.838A

T82.848A

T82.858A

T82.868A

T82.898A

T80.219A

T80.211A

T80.212A

The replacement or exchange of tunneled catheter is mainly done due to complication due to atheter or malfunction of the catheter. The above ICD 10 codes are coded when there is any mechanical complication related to venous catheter. The infection due to central venous catheters has separate ICD 10 codes.
 

Do and Don’t- CPT code tunneled catheter exchange or Replacement

Code any guidance used for the replacement of central venous catheter like ultrasound guidance (76937) or Fluoroscopic guidance (77001). Code the removal of tunneled catheter separately when the replacement of same type of tunneled catheter is done through different access site. (Since the replacement in this case becomes the placement procedure codes 36561-36569)
 
Do not code the removal of tunneled catheter code 36589-36590 when the catheter is replaced through the same access site. (The removal codes are included with replacement codes)
 
When a tunneled catheter is removed and replaced with non-tunneled catheter, do code the removal of tunneled catheter as well the placement of non-tunneled catheter code since this is not actually a replacement procedure since the tunneled catheter is not replaced by a tunneled catheter.
 

When a non-tunneled catheter is replaced with a tunneled catheter only placement of tunneled catheter is coded.

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