Cardiology Coding Alert

Question: My physician noted that he inserted a central line through the right femoral vein and a triple lumen catheter was advanced over the wires into the right femoral vein. To code 36556 (patient is over 5 years old) the line has to terminate in the subclavian, brachiocephalic, iliac vein; the superior or inferior vena cava; or the right atrium. What is the code if it didn’t terminate in any of the above areas?

Codify Member

Answer: You should choose a venous introduction code based on the complete service performed. For instance, compare the documentation to 36000 (Introduction of needle or intracatheter, vein).

This case emphasizes the importance of coding the service actually performed rather than letting a term dictate code choice. If the catheter terminated in the femoral vein, then you should code that service rather than using 36556 (Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older).

Caution: Before reporting a catheter placement code, such as 36000, ensure that the code isn’t included in another service performed during the same session, such as an anesthesia service or vascular access for critical care. Review code edits and guidelines before capturing the code.