2025 CPT code 36556
(Active) Effective Date: N/A Revision Date: N/A Surgical Procedures - Cardiovascular System Surgery Feed
Insertion of a non-tunneled central venous access catheter in patients aged 5 years or older without imaging guidance.
Modifiers may be applicable depending on the circumstances of the procedure. For example, modifier 59 (distinct procedural service) may be necessary if another procedural service was performed on the same day that does not meet usual components of the main service. Consult the latest CPT guidelines for appropriate modifier use.
Medical necessity for a central venous catheter is established when there's a need for frequent intravenous access for medication administration (e.g., chemotherapy, long-term antibiotics), total parenteral nutrition (TPN), or fluid management.Documentation should support the clinical indication, the inability to achieve adequate venous access through peripheral sites, and the suitability of a central venous catheter for the patient's condition.
The physician is responsible for administering local anesthesia, performing the percutaneous insertion of the catheter into the selected vein, ensuring proper placement of the catheter tip within the designated central venous system, and securing the catheter externally.
In simple words: The doctor inserts a thin tube (catheter) into a large vein in the neck, chest, or groin to give medicine, fluids, or nutrients. This is done in people 5 years and older without using imaging like x-rays to guide the placement. A small part of the tube stays outside the skin and is taped down.
This CPT code encompasses the insertion of a non-tunneled central venous access catheter, without the use of imaging guidance, in patients five years of age or older.The procedure involves percutaneous insertion into a major vein (jugular, subclavian, or femoral vein, or inferior vena cava), with the catheter tip terminating in the subclavian, innominate, or iliac veins, superior or inferior vena cava, or right atrium.Local anesthesia is administered prior to catheter insertion. The catheter is secured externally to the skin to prevent accidental removal.This code does not include the use of imaging guidance (fluoroscopy or ultrasound).
Example 1: A 60-year-old male patient is admitted for chemotherapy.A non-tunneled central venous catheter is placed to administer chemotherapy agents intravenously., A 10-year-old child requires long-term intravenous antibiotics.A non-tunneled central venous catheter is inserted for medication administration., An adult patient needs total parenteral nutrition (TPN) after major surgery.A non-tunneled central venous catheter is placed for TPN administration.
The medical record must document the patient's age, the site of venous access (jugular, subclavian, femoral, or inferior vena cava), the precise location of the catheter tip, the type of catheter used (non-tunneled, without port or pump), the method of insertion (percutaneous), confirmation of catheter patency, and the absence of imaging guidance during placement.A description of the procedure, including any complications, is also needed.Pre-operative and post-operative assessment should be included.
** Always verify the code's applicability based on the specific details of the procedure performed and the patient's age.Incorrect coding can lead to claim denials.Consult the current CPT manual and other relevant coding resources to ensure accurate billing.
- Revenue Code: P6C (Medicare Fee Schedule: MINOR PROCEDURES - OTHER)
- RVU: The relative value units (RVUs) for this code are determined by the Medicare Physician Fee Schedule (MPFS) and can vary based on geographic location and other factors.Consult the MPFS for the most current RVU values.
- Global Days: The global period for this procedure is not explicitly defined within the provided dataset. Further clarification on the global surgical period is needed for accurate reimbursement. This likely varies based on payer and specific circumstances.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier does not typically apply to this code as it represents the entire service.The professional component (26) may be used if appropriate.
- Fee Schedule: Historical fee schedule data is not readily available within this dataset; please refer to historical Medicare Physician Fee Schedules (MPFS) for past reimbursement rates.
- Specialties:Vascular Surgery, Cardiology, Oncology, Interventional Radiology, Anesthesiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center