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Tunnelled PICC

  1. Default Tunnelled PICC
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    Good Morning,

    What would be the appropriate CPT code for Tunneled PICC placement? Is it correct to use 36568/36569 as per age criteria?

    A patient was placed a 5 french single lumen powerline catheter with a subcutaneous cuff.

    I really appreciate your valuable feedback.

    Siva, CPC, CPC-H.

  2. Default Peripheral tnneld PICC

    Look at code 36571.

  3. Default
    Hi I was under the impression that PICC procedures have no code set for tunneled procedure, becaus eit is a totally diferent route ,meaning the port of entry itself is straight into peripheral vein.
    I was under the impression that PICC is different from tunneled because the tunneled goes beneath the skin like a tunnel to reach its destiny of central venous system(via jugular vein); whereas the PICC is just select a periphral vein like cubital and reaches its destiny.

    So do you mean to say the 'Device' at 3657x is a 'tunneled'. I am confused why would you select 3657x for the tunneled
    I am not aware of it.
    Can any one throw some light on this.
    Last edited by preserene; 08-30-2010 at 08:44 PM.

  4. #4
    Fayetteville, NC
    I would need to see more of the OP note to be comfortable attempting to code that.
    Did the physician say it was a PICC line or are you calling it a PICC line? Did the physician say it was tunneled because in that statement I do not see tunneled? How old was the patient? Why was the device placed?

  5. Default Tunneled picc line placement
    Please find the report and suggest appropriate CPT.
    Clinical history:

    54-year-old male HIV positive with osteomyelitis, requiring
    long-term IV antibiotics. Request is made for a tunneled PICC

    Procedure: Ultrasound and fluoroscopy guided tunneled PICC

    Informed consent was obtained after discussing risks, benefits and
    alternatives. Risks discussed included but were not limited to
    bleeding, infection, venous thrombosis etc.

    Preliminary ultrasound was performed of the left arm demonstrating
    a patent basilic vein. The left arm was prepped and draped in
    usual sterile manner and locally anesthetized with 1% lidocaine.
    Under real-time ultrasound guidance the left basilic vein was
    accessed with a micropuncture set. A sonographic image was stored
    for the medical record.

    A 5-French single lumen Bard Powerline with subcutaneous cuff was
    then tunneled to the puncture site.
    The puncture site was dilated
    and a peel-away sheath placed. The catheter was advanced through
    the peel-away sheath, positioned with the tip in the super vena
    cava. The peel-away sheath was removed and hemostasis achieved
    with manual compression. The catheter was sutured in place with
    Prolene and a sterile dressing applied. No immediate

    Ultrasound and fluoroscopy guided placement of a tunneled single
    lumen PICC line (Bard Powerline) via left basilic vein
    . Catheter length is 49 cm.

  6. #6
    Fayetteville, NC
    OK one more question was there a subcutaneous port?
    If I go by the OP note alone (which I always do) then this would be 36569 as there is no subcutaneous port mentioned.

  7. #7
    United Aram Emirates
    this is a PICC line, though he is using word tunnelled, actually no work was done to creat a tunnel in the report. it would be 36569.

    Harish, CCS, CPC

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