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Wiki Tunneled cath removal

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Licorice5

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A cath was inserted in June (36558) and paid by Medicare. The end of August this cath was removed (36589) and denied as already included in payment for another service. These were the only 2 services provided. I cannot find where the removal is included in the insertion code and the global days are 10 so it's well after the global period.
Any suggestions?
 
tunneled catheter removal

CPT 36558 is insertion of a tunneled central venous catheter (i.e. perm cath for dialysis). The removal of the device is included with the placement and no charges should be billed. Same for removing a feeding tube.
 
In the case of a tunneled catheter, the removal is NOT included. There is a separate code as the original poster noted. Removal of a non-tunneled catheter is not separately billed, but removal of a tunneled cath requires more work and so was valued separately.
 
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