2025 CPT code 36566
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgical Procedures on the Cardiovascular System - Insertion of Central Venous Access Device Surgery Feed
Insertion of a tunneled, centrally inserted central venous access device requiring two catheters via two separate venous access sites; with subcutaneous port(s).
Modifiers may be applicable depending on the circumstances of the procedure (e.g., 50 for bilateral procedures, 59 for distinct procedural services, or others). Refer to the CPT manual for specific guidance on modifier usage.
Medical necessity is established when a patient requires long-term venous access for medications (e.g., chemotherapy, antibiotics) or intravenous fluids (e.g., parenteral nutrition) that cannot be safely or effectively delivered through peripheral veins.The choice of tunneled CVC over other access methods depends on individual patient needs and factors like treatment duration and medication characteristics.Appropriate documentation must support the clinical justification.
The physician's responsibilities include pre-operative planning, obtaining informed consent, performing the insertion procedure under appropriate sterile conditions, confirming proper catheter placement (often with imaging), and providing post-operative care instructions.This might involve local anesthesia, surgical incision(s), and use of imaging guidance.
In simple words: This code describes a surgical procedure to place a long thin tube (catheter) into a large vein near the heart.Two tubes are placed through separate small cuts in the skin. The tubes are then run under the skin to a place on the chest where they will be accessible for medication or blood draws. There are also small chambers attached (ports) that sit under the skin.
This CPT code encompasses the insertion of a tunneled, centrally inserted central venous access device.The procedure involves placing two catheters through two separate venous access sites, each terminating in a central vein (such as the superior vena cava or right atrium).Subcutaneous ports are included as part of the device.The catheters are tunneled beneath the skin, creating a pathway between the insertion and exit sites. The procedure typically requires imaging guidance (fluoroscopy) and local anesthesia.
Example 1: A patient with cancer requires long-term venous access for chemotherapy administration. A double-lumen tunneled catheter with subcutaneous ports is inserted to facilitate repeated drug delivery., A patient with chronic kidney disease needs regular hemodialysis. A tunneled central venous catheter with two lumens is implanted to ensure efficient blood access during dialysis sessions., A patient requires parenteral nutrition support. A tunneled central venous catheter with a subcutaneous port is inserted for long-term administration of nutrients.
Complete operative report including specifics of catheter type, number of lumens, type of port, insertion site, and exit site.Documentation must include imaging confirmation of proper catheter position and details regarding sterile technique.Pre-operative patient consent form, post-operative care instructions, and follow-up notes are also required.
** Careful documentation is vital for accurate coding.Note the specifics of the catheter (single or double lumen, type of port), the imaging guidance used (if any), and any complications or unusual circumstances encountered during the procedure.
- Revenue Code: P6C (Medicare Fee Schedule: MINOR PROCEDURES - OTHER)
- RVU: RVUs vary based on geographic location and other factors.Consult the Medicare Physician Fee Schedule or other relevant payer guidelines for current RVU values and payment rates.
- Global Days : The global period is not explicitly defined for this code.Check payer-specific guidelines for potential global surgical packages.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier might apply, particularly if the service is performed by a physician's assistant or other qualified personnel under the supervision of a physician.
- Fee Schedule : Fee schedules vary by payer, location, and time period.Refer to historical Medicare Physician Fee Schedules or other relevant payer guidelines to assess past fee data.
- Specialties:Oncology, Hematology, Nephrology, Intensive Care Medicine, Vascular Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center