2025 CPT code 36595
(Active) Effective Date: N/A Revision Date: N/A Surgery - Central Venous Access Device Procedures Surgery Feed
Removal of obstructive material from a central venous access device via a separate venous access.
Modifiers may be applicable depending on the circumstances of the procedure, including but not limited to: 59 (distinct procedural service), 78 (unplanned return to the operating/procedure room), and modifiers indicating the use of imaging guidance.
Medical necessity for 36595 is established when a central venous access device is occluded or partially occluded, impacting the delivery of medication, fluids, or blood sampling.Documentation must support the clinical need for the procedure, the type of obstruction, the technique used for removal, and the restoration of function.
The physician is responsible for the insertion of the access instrument, removal of the obstructive material, and restoration of CVAD functionality. This may involve fluoroscopic guidance or other imaging techniques.
In simple words: The doctor removes a blockage (like a clot) from a central line (a tube in a large vein) using a separate entry point. This unclogs the line to allow for proper blood flow or medication delivery.
This CPT code represents the mechanical removal of obstructive material, such as fibrin sheath or thrombus, from a central venous access device (CVAD). The procedure involves accessing the CVAD through a separate venous access site, distinct from the original CVAD insertion site.Various instruments, including guidewires, snares, or biopsy brushes, may be used to remove the obstructive material and restore patency.This is distinct from procedures that address occlusion within the catheter lumen itself.
Example 1: A patient with a tunneled central venous catheter experiences a decreased infusion rate.The physician determines that a fibrin sheath has formed around the catheter tip.Under fluoroscopic guidance, a separate venous access is established and a guidewire is advanced to remove the obstructive material. Code 36595 is reported., A patient's implanted port is malfunctioning. Upon examination, the physician finds that a thrombus has occluded the port. Using a separate venous access, the physician removes the thrombus and restores the port functionality. Code 36595 is reported., A patient with a non-tunneled central venous catheter develops an occlusion. The physician utilizes a separate venous access to remove the obstructing material using a specialized catheter.Code 36595 is reported, along with any imaging guidance codes used.
* Pre-procedure assessment of the CVAD and symptoms.* Documentation of the method used to access the CVAD for removal of obstructive material (e.g., guidewire, snare, etc.).* Description of the material removed (e.g., fibrin sheath, thrombus).* Confirmation of restoration of CVAD patency and functionality.* Imaging studies if utilized (and separate reporting of those codes).* Operative report or procedural notes detailing the technique used, findings, and any complications.
** Always refer to the most current CPT codebook and coding guidelines for definitive information regarding code usage, modifiers, and reimbursement policies.Consider payer-specific guidelines and local coverage determinations (LCDs).
- Revenue Code: P6C (Medicare Fee Schedule: MINOR PROCEDURES - OTHER)
- RVU: The relative value units (RVUs) for this code are subject to change and vary based on location (geographic practice cost index) and other factors. Consult the CMS website or a medical billing resource for the most current RVU data.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not typically applicable to 36595, as this is a comprehensive procedure.
- Fee Schedule: Fee schedule data varies based on payer, location, and date. Consult your payer's fee schedule or a relevant medical billing resource for specific historical fee schedule data.
- Specialties:Vascular Surgery, Interventional Radiology, Cardiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center