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Outpatient Facility Coding Alert

Reader Question:

Get All the Details Before Choosing a Catheter Code

Published on Thu May 19, 2016 Print Friendly and PDF PDF

Question: Our surgeon inserted a non-tunneled catheter for a three-year-old patient. How should we code the service?

Codify Subscriber

Answer: The patient’s age is important when choosing a catheter code, but that’s not the only detail you need to confirm. For example, you need to know whether the catheter was peripherally or centrally inserted. The answer to that question would lead to one of the following codes:

  • 36555 — Insertion of non-tunneled centrally inserted central venous catheter; younger than 5 years of age
  • 36568 — Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump; younger than 5 years of age.

Tip: You don’t provide enough information for a definitive answer here. When coding these cases, verify the following information to select the proper code for venous access procedures:

  • What is the patient age (less than 5 years, or 5 years or older?) 
  • Is the catheter tunneled or not? 
  • Is the line centrally placed or peripherally placed?
  • Is there a port or pump?

With the answer to those questions, you should always be able to choose the proper code in the range 36555-36571.

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