Radiology Coding Alert

Question: What codes would I assign when a PICC line was removed from the upper arm vein and a new one was inserted with its distal tip placed within the proximal right atrium? Georgia Subscriber Answer: No code exists that describes the removal of a peripherally inserted central catheter (PICC) line or any other non-tunneled line without an implantable portion (e.g., a port). Therefore, you are unable to code for removing the PICC line. The placement of the new line is coded as 36489* (Placement of central venous catheter [subclavian, jugular, or other vein] [e.g., for central venous pressure, hyperalimentation, hemodialysis, or chemotherapy]; percutaneous, over age 2), if the patient is older than 2. When fluoroscopic guidance is used, you would also report 76000 (Fluoroscopy [separate procedure], up to one hour physician time, other than 71023 or 71034 [e.g., cardiac fluoroscopy]) or 76003 (Fluoroscopic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device]).