2025 CPT code 77001
(Active) Effective Date: N/A Revision Date: N/A Radiology Procedures - Radiologic Guidance Radiology Feed
Fluoroscopic guidance for central venous access device (CVAD) placement, replacement, or removal; add-on code only.
Modifiers 26 (professional component), 59 (distinct procedural service), and others may be applicable depending on the circumstances of the service. Refer to CPT guidelines for appropriate modifier usage.
Medical necessity for fluoroscopic guidance during CVAD placement, replacement, or removal is established when the physician deems it necessary to ensure accurate and safe catheter placement, especially in complex anatomical situations or when minimizing risks of complications such as pneumothorax, arterial puncture, or hematoma is crucial.Documentation should justify the use of fluoroscopy, describing the clinical reasons why it was necessary.
The physician performing the primary procedure (CVAD placement, replacement, or removal) is responsible for providing the fluoroscopic imaging service.This includes administering anesthesia, preparing the insertion site, inserting the guidewire, advancing the catheter, injecting contrast if needed, and confirming final catheter placement using fluoroscopy and imaging. The physician also interprets the images.
In simple words: This code is added to the bill for a procedure that places, replaces, or removes a thin tube in a large vein (a central venous access device or CVAD).It covers the use of X-ray imaging (fluoroscopy) to guide the placement of the tube and make sure it's in the right spot. This code can't be billed on its own; it must be with the main procedure code for the CVAD work.
This CPT code, 77001, represents fluoroscopic guidance for central venous access device (CVAD) placement, replacement (catheter only or complete), or removal.It includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through the access site or catheter with related venography, radiologic supervision and interpretation, and radiographic documentation of the final catheter position.This code is exclusively an add-on code and cannot be billed independently; it must accompany the primary procedure code for CVAD insertion, replacement, or removal.The procedure involves imaging the pathway of the CVAD catheter insertion using fluoroscopy, guiding the catheter to its final position in the central vein, and documenting its placement radiographically. Contrast injections may be used to enhance visualization.
Example 1: A patient requires a tunneled central venous catheter (CVC) placement for long-term chemotherapy administration.The physician uses fluoroscopy to guide the catheter insertion into the subclavian vein, ensuring proper placement in the superior vena cava. Code 77001 is added to the primary procedure code for CVC placement., A patient's peripherally inserted central catheter (PICC) needs replacement. Fluoroscopy is used to guide the removal of the old catheter and the insertion of the new catheter. Code 77001 is appended to the primary procedure code for PICC replacement., A patient's implanted port requires access.The physician uses fluoroscopy to locate the port and guide the needle insertion. Contrast injection is used to verify proper needle placement. Code 77001 is added to the code for accessing the implanted port.
Complete procedural documentation should include patient demographics, indication for the procedure, type of CVAD (e.g., PICC, tunneled CVC, implanted port), site of access, details of the fluoroscopic guidance technique used (including contrast used, if any), images confirming catheter placement, and post-procedure assessment.Appropriate informed consent should also be documented.
** Accurate documentation is crucial for proper reimbursement.Any discrepancies in documentation may lead to claim denials.Always refer to the latest CPT guidelines and payer-specific coding policies for the most up-to-date information.
- Revenue Code: I4B (IMAGING/PROCEDURE - OTHER)
- Payment Status: Active
- Modifier TC rule: Modifier TC (technical component) is typically not applicable to this add-on code, as it is a professional service.
- Specialties:Vascular Surgery, Interventional Radiology, Cardiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center