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2025 CPT code 36555

Insertion of nontunneled centrally inserted central venous catheter in a patient younger than 5 years of age.

This code is specifically for patients younger than 5 years old. Use 36556 for patients 5 years or older. If imaging guidance (fluoroscopy or ultrasound) is used and billed separately, append modifier 59 to the imaging guidance code (76937 for ultrasound, 77001 for fluoroscopy).

Modifiers may be applicable to this code, such as modifier 22 (Increased Procedural Services) if the procedure was significantly more complex than usual.

Medical necessity for 36555 must be supported by documentation indicating the clinical reason for requiring central venous access, such as the need for intravenous fluids, medications, or frequent blood sampling.

After administering local anesthesia, the physician inserts a needle into the vein and guides the catheter into place, usually using x-ray (fluoroscopy). The catheter is secured to prevent accidental removal or movement.

IMPORTANT:For peripherally inserted non-tunneled central venous catheter for a patient younger than 5 years of age, use 36568.

In simple words: The doctor inserts a small tube called a catheter into a vein in your child's neck, chest, or groin. This catheter can be used to take blood samples or give fluids and medicines.This is a short-term catheter that stays in for a few weeks.

Insertion of a nontunneled centrally inserted central venous catheter for patients under 5 years old. This includes percutaneous insertion of a catheter into the jugular, subclavian, or femoral vein (or sometimes the inferior vena cava) under fluoroscopic guidance. The catheter tip must terminate in the brachiocephalic, iliac, or subclavian vein, the superior or inferior vena cava, or the right atrium.

Example 1: A 3-year-old child with severe dehydration requires intravenous fluids and medications. A nontunneled central venous catheter is inserted to provide reliable venous access., A 1-year-old infant needs long-term intravenous antibiotics for a serious infection. A nontunneled central venous catheter is inserted to avoid repeated needle sticks for IV access., A 4-year-old child with cancer requires frequent blood draws and chemotherapy. A nontunneled central venous catheter is inserted to facilitate these procedures and minimize discomfort.

Documentation should include the type of catheter inserted, the site of insertion, the method of insertion (e.g., fluoroscopic guidance), and any complications encountered.

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