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2025 CPT code 36557

Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; younger than 5 years of age.

Use this code for patients under 5 years of age. For patients 5 years or older, use 36558.If a port or pump is also inserted, use the appropriate code (36561, 36563, 36565, 36566). Modifier 22 may be appended if the procedure is significantly more complex than usual.

Modifiers may be applicable to this code. Common modifiers include: -22 (Increased Procedural Services) if the procedure is substantially more difficult -52 (Reduced Services) if a portion of the procedure is not performed -59 (Distinct Procedural Service) to distinguish from another procedure performed during the same encounter

Medical necessity must be documented for this procedure. This includes justification for long-term venous access due to the patient's condition, such as long-term medication administration, parenteral nutrition, or frequent blood draws.

The physician is responsible for prepping and anesthetizing the patient, locating the target vein, inserting the catheter using appropriate guidance (ultrasound or fluoroscopy), creating the tunnel, securing the catheter, controlling bleeding, and irrigating the site with antibiotics.

In simple words: Placement of a flexible tube under the skin and into a large vein near the heart in a child less than 5 years old. This tube allows easy access to give medicines, fluids, or take blood samples for a longer period of time.

This code describes the insertion of a tunneled central venous catheter in a child under the age of 5.The catheter is inserted into a central vein (e.g., subclavian, jugular, femoral) and tunneled under the skin to an exit site on the chest or abdomen.It does not include a subcutaneous port or pump.This provides long-term venous access for medications, fluids, or blood draws.

Example 1: A 3-year-old child with leukemia requires long-term chemotherapy and frequent blood draws. A tunneled central venous catheter is inserted to facilitate these treatments., A 1-year-old infant with short bowel syndrome requires long-term parenteral nutrition. A tunneled central venous catheter is inserted to administer the nutrition., A 4-year-old child with a severe infection requires long-term intravenous antibiotics.A tunneled central venous catheter is inserted to avoid repeated peripheral IV placements.

Documentation should include: patient consent, type and size of catheter, insertion site and exit site, method of insertion (e.g. ultrasound guidance), confirmation of placement (e.g. chest x-ray), and any complications encountered.

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