Wiki PLEASE clarify 36410 vs 36569

[ljones88]

Hi all,

I swear I have my handle on these line inertion procedures and then I get confused again...
Can someone please clarify for me the difference between cpt code 36410 and 36569.

Patient underwent PICC line insertion into right forearm by ED physician prior to admitting to inpatient due to ongoing cardiac and syncope workup. Physician is coding 36410 (venipuncture) and I believe documentation supports 36569.

 

[JulieRamone]

I have the same question!

 

[trarut]

36410 is for a needle inserted into a vein for blood collection

From Codify: The provider places the patient in a suitable position to ensure normal blood flow. He inserts a needle attached to a flexible tube through the skin into the vein while putting thumb pressure to the skin a couple of inches below the puncture site, which helps in steadying the vein during the puncture. The provider confirms the placement of the needle by checking the blood flow in the needle and inserts it farther very slowly and carefully to avoid piercing the posterior wall of the vein. After collecting blood or infusing a drug, he withdraws the needle and applies the pressure to stop the bleeding.​

36569 is for a catheter placement using a guidewire to administer a drug or fluid

From Codify: When the patient is appropriately prepped and anesthetized, the provider locates the basilic or cephalic vein in the upper extremity of the patient; he inserts the tip of catheter through the skin and inserts a guidewire. The provider then guides the catheter over the guidewire into one of the target veins. Options for target veins include the brachiocephalic or innominate, the iliac vein, the subclavian, or the superior or inferior vena cava. Alternatively, he may insert the catheter directly into the right atrium of the heart. After placing the catheter, he withdraws the guidewire, controls bleeding and irrigates the insertion site with antibiotics. The provider does this to administer a medication or fluid directly into the blood stream.​

Hope this helps.