2025 CPT code 36593
(Active) Effective Date: N/A Revision Date: N/A Surgical Procedures on the Cardiovascular System - Other Central Venous Access Procedures Surgery Feed
Declotting of an implanted vascular access device or catheter using a thrombolytic agent.
Modifiers may be applicable depending on the circumstances of the procedure. Consult the latest CPT guidelines for appropriate modifier usage.
Medical necessity for code 36593 is established when a clot obstructs a central venous catheter, compromising venous access and the delivery of essential medications or fluids.Documentation should support the clinical need for the procedure.
A physician, or possibly a registered nurse under physician supervision, is responsible for administering the thrombolytic agent and monitoring the patient's response.
- Surgery
- Surgical Procedures on the Cardiovascular System > Surgical Procedures on Arteries and Veins > Vascular Introduction and Injection Procedures > Central Venous Access Procedures > Other Central Venous Access Procedures
In simple words: The doctor uses a special medicine to dissolve a blood clot inside a tube (catheter) or device already placed in a vein. This helps clear the blockage and allows the device to work properly again.
This CPT code, 36593, reports the procedure of removing an obstructing clot from an implanted vascular access device or catheter using a thrombolytic agent, such as tissue plasminogen activator (tPA).The procedure involves administering the thrombolytic agent directly into the device or catheter to dissolve the clot, restoring patency. This code specifically addresses the treatment of the device itself and not the underlying vascular pathology.
Example 1: A patient with a centrally inserted venous catheter experiences a clot in the catheter.The physician performs a declotting procedure using tPA via injection into the catheter lumen, reported with code 36593., A patient with a peripherally inserted central catheter (PICC) develops a thrombus within the catheter lumen. The physician uses tPA to dissolve the clot, which is appropriately coded as 36593., A patient with a port-a-cath experiences catheter occlusion.Following unsuccessful attempts at mechanical declotting, the physician injects a thrombolytic agent and reports the procedure with code 36593.
* Documentation should clearly indicate the presence of an obstructive clot in the implanted vascular access device or catheter.* The type of thrombolytic agent used should be specified.* The method of administration (injection into the catheter lumen) should be documented.* The amount of thrombolytic agent administered should be recorded.* Pre- and post-procedure assessments of catheter patency should be documented.* Any complications should be noted.
** This code should not be used if the clot is removed by mechanical means without the use of a thrombolytic agent.Always refer to the latest CPT manual for the most current coding guidelines.
- Revenue Code: P6C (Medicare Fee Schedule: MINOR PROCEDURES - OTHER)
- RVU: Refer to the current Medicare Physician Fee Schedule for RVU values and payment rates.RVUs will vary based on geographic location and other factors.
- Global Days: Not applicable. This is not a surgical procedure with a global period.
- Payment Status: Active
- Modifier TC rule: Not applicable.This is not a procedure that involves separate professional and technical components.
- Fee Schedule: Fee schedules vary by payer and location.Consult the appropriate fee schedule for the relevant period.
- Specialties:Vascular Surgery, Interventional Radiology, Oncology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center