2025 CPT code 36860
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
External cannula declotting (separate procedure); without balloon catheter.
Modifiers 51 (Multiple Procedures) and 59 (Distinct Procedural Service) may be applicable depending on the circumstances of the service provided.
Medical necessity for 36860 is established when there is evidence of a clot obstructing the flow through an external cannula, causing complications such as impaired medication delivery or impaired hemodialysis.Documentation must justify the need for the procedure and the chosen method.
The clinical responsibility lies with the physician or qualified healthcare professional who performs the declotting procedure. This includes proper preparation and anesthesia of the patient, injection of the medication, and monitoring the patient's response to the procedure.
In simple words: This medical code refers to removing a blood clot from a tube (cannula) inserted into a blood vessel.A special medicine is injected into the tube to dissolve the clot, without using a balloon-tipped catheter.
This CPT code 36860 describes the removal of a clot from an external cannula without the use of a balloon catheter.The procedure involves injecting a solution containing an anticoagulant or thrombolytic medication into the cannula to dissolve or break up the clot. This is performed as a separate procedure following the initial cannula placement.
Example 1: A patient with an arteriovenous (AV) fistula for hemodialysis experiences clotting in the external cannula. The physician performs a declotting procedure using 36860, injecting thrombolytic medication without a balloon catheter., A patient with a temporary central venous catheter develops a clot. The healthcare provider uses 36860 to remove the clot without using a balloon catheter, injecting anticoagulant medication into the cannula., A patient post-surgery has a clot in an external cannula used for medication administration. The physician uses 36860 to declot the cannula, utilizing an anticoagulant to dissolve the clot, and avoids using a balloon catheter.
Complete medical record documentation is necessary for accurate coding of 36860. This should include details of the cannula placement, the reason for the declotting procedure (e.g., clot formation, impaired blood flow), the method used for declotting (without balloon catheter), the medication administered (with dosage and route of administration), the patient's response to the treatment, and any complications encountered.
** This code should only be used when a balloon catheter is not used in the declotting procedure.Appropriate documentation is crucial for reimbursement.Consider the use of modifiers as appropriate.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- Payment Status: Active
- Specialties:Vascular Surgery, Nephrology, Interventional Radiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgery Center