Results 1 to 9 of 9

Placement of Venous Access Device

  1. #1
    Default Placement of Venous Access Device
    Exam Training Packages
    Hell everyone.

    Please help with the following report 36561 vs. 36558

    Procedure: Place of venous access device using ultrasound, fluoroscopy, subcutaneous tunnel. History: The patient is a 27-yr. old male with sickle cell anemia. He is going to udergo apheresis. A double-lumen port was requested to faciliatate the administration. Risk explained.

    Procedure Details : Patient was taken to the OR. Given adequate general endotracheal aesthesia. The right neck and chest were prepped with chlorhexidine and draped in a sterile and appropriate fashion. The patient had been given IV antibiotics. Time-out was performed as per protocol. The right IJ was found with ultrasound. The needle was placed in right IJ using ultrasound guidance. The guidewire was placed. Fluoroscopy was used to confirm good placement. A pocket was created on the right upper chest. The tunneling device connected the pocket to the venipuncture site. A double-lumen Vortex catheter was in place. I was brought up through the tunnel, placed through the tearaway sheath, positioned in the superior vena cava. It was then attached to the reservoir. The locking device was engaged appropriately. It was secured in the pocket with 2-0 Vicrly. It aspirated and flushed easily. The pocket was closed. The neck incision was closed. Sent to recovery. Chest x-ray show good placement.


  2. #2
    Default Placement of Venous Access Device
    Hi You might want to look at code 36566? and dont forget to
    code for the the US guidance 77001 with 26TC
    Deb, CPC

  3. #3
    Default Placement of Venous Access Device
    Tks, I did remember to use the 77001 with 26 modifier. However, it was a tunneled device. I believed that 36561 was correct because of the port. However, another coder believes it 36558 because of the pocket.
    Any advice?

  4. #4
    I agree with 36561. Also, the op note states both fluoroscopy and US guidance were used, so I would add both 77001-26 and 76937-26.

  5. #5
    Coeur d'Alene

    We do these alot. I would use the 36561 but we do not use the 76937 my doctors have alsways said that that is included in the procedure. They would never do the procedure without.


  6. Default
    We also do alot of these we would use the 36561 and 77001-26 we do not code the 76937-26. Is anyone getting paid by coding all three? I have typed in an example on my code Correct and it did say you could use all three. There were no LCD's found. Corresponding procedure(s) for use of 76937 may include: 36555, 36556, 36557, 36558, 36560, 36561, 36563, 36565, 36566, 36568, 36569, 36570, 36571, 36575, 36576, 36578, 36580, 36581, 36582, 36583, 36584, 36585.

  7. #7
    Fort Worth Texas
    I was taught that when a pocket is created, it is code 36561. We bill 77001-26 along with it for the fluoro. Cath's always confused me until someone shared that nugget! Then 'pocket' became my favorite word!


  8. #8
    Phoenix, AZ
    Interesting! What if the MD places a venous sheath for venous access. There is no termination in the subclavian, brachiocephalic or iliac.
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

  9. #9
    We get paid for both 77001-26 and 76937-26. Our surgeons do not use it every time, and I have never been told that it is included in 36561.

Similar Threads

  1. Replies: 2
    Last Post: 05-25-2012, 08:57 AM
  2. Venous Access Device
    By in forum General Surgery
    Replies: 2
    Last Post: 12-12-2011, 03:45 PM
  3. conversion of a non-tunneled device to a tunneled device via same access site.
    By DONNA O. LINDSEY in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 07-19-2010, 08:08 AM
  4. Exposed Venous Access port/Need for intravenous access
    By Trendale in forum General Surgery
    Replies: 2
    Last Post: 05-12-2009, 02:50 PM
  5. venous access
    By heathermc in forum General Surgery
    Replies: 5
    Last Post: 12-08-2008, 11:08 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.