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Removal of porta Cath CPT code

  1. Default Removal of porta Cath CPT code
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    Hi,

    A physician remove a Port-a-Cath but he did not mention about tunnel or non-tunnel which is the correct CPT code for the following service. there are only two codes but both of them are for tunnel 36589 and 36590 should i take 36590 or ??????> he also perform resection of fibrous capsule.
    Vikas Maheshwari
    Operation Manager (Medical Billing & Coding)
    MBA-HCS, CPC-H

  2. #2
    Location
    Birmingham, Alabama
    Posts
    889
    Default
    Quote Originally Posted by Vikas Maheshwari View Post
    Hi,

    A physician remove a Port-a-Cath but he did not mention about tunnel or non-tunnel which is the correct CPT code for the following service. there are only two codes but both of them are for tunnel 36589 and 36590 should i take 36590 or ??????> he also perform resection of fibrous capsule.
    Can you post the report? If not, you need to ask the physician what type of central catheter he removed (tunnelled? with port?)

    If it was not tunnelled, that does not meet the requirements for a procedure and is included in the visit code (E&M code).

    HTH
    Danny L. Peoples
    CIRCC,CPC

  3. Default
    here is the report


    With the patient in the supine position, the left chest was prepped and draped in a sterile fashion. 1% lidocaine was infiltrated in the area of the previous incision on the anterior left chest and then infiltrated into the pocket surrounding the Port-a-cath. A 2 cm transverse incision was made and carried down to the level of the capsule on the existing Port-a-cath. The Catheter and going up towards the subclavian vein was identified and grasped with an Allis clamp and then tretracted easil. The catheter appeared clean without evidence of infection or thrombus. the stitch holding the Port-a-cath to the pectoral fascia was then identified and divided. the complete capsule holding the device was then opened and the specimen removed. the fibrous capsule was then excised using electrocautery and sent for culture. the hemostasis was obtained. the wound was cloed with running layers of 2-o vicryl suture.
    Vikas Maheshwari
    Operation Manager (Medical Billing & Coding)
    MBA-HCS, CPC-H

  4. #4
    Location
    Birmingham, Alabama
    Posts
    889
    Default
    Quote Originally Posted by Vikas Maheshwari View Post
    here is the report


    With the patient in the supine position, the left chest was prepped and draped in a sterile fashion. 1% lidocaine was infiltrated in the area of the previous incision on the anterior left chest and then infiltrated into the pocket surrounding the Port-a-cath. A 2 cm transverse incision was made and carried down to the level of the capsule on the existing Port-a-cath. The Catheter and going up towards the subclavian vein was identified and grasped with an Allis clamp and then tretracted easil. The catheter appeared clean without evidence of infection or thrombus. the stitch holding the Port-a-cath to the pectoral fascia was then identified and divided. the complete capsule holding the device was then opened and the specimen removed. the fibrous capsule was then excised using electrocautery and sent for culture. the hemostasis was obtained. the wound was cloed with running layers of 2-o vicryl suture.
    I would code the removal 36590. I think the "capsule" is the port and as such is included, no additional codes needed.

    HTH
    Danny L. Peoples
    CIRCC,CPC

  5. Default
    thanks
    Vikas Maheshwari
    Operation Manager (Medical Billing & Coding)
    MBA-HCS, CPC-H

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