2025 CPT code 36576
(Active) Effective Date: N/A Surgical Procedures on Arteries and Veins - Vascular Introduction and Injection Procedures Surgery Feed
Repair of central venous access device, with subcutaneous port or pump, central or peripheral insertion site.
Modifiers may apply.For example, use modifier 76 for repeat procedures by the same physician, 59 for a distinct procedural service, or 22 for increased procedural services.
Medical necessity for repair is established when the existing CVAD is malfunctioning, obstructing, infected, or otherwise compromised in a way that hinders its intended function. The repair should be necessary to restore or maintain access for essential therapies or monitoring.
The physician is responsible for prepping and anesthetizing the patient, accessing the subcutaneous port or pump, assessing the device for damage, performing the necessary repairs which could include catheter manipulation or component replacement without a full exchange, ensuring device patency, closing the incision site, and applying a sterile dressing.
In simple words: This procedure fixes a problem with an implanted device under your skin that's used to give you medicine or fluids directly into your bloodstream.The doctor will repair the device without replacing it entirely.
This procedure involves the repair of a previously placed central venous access device (CVAD) that includes a subcutaneous port or pump.The repair focuses on correcting issues with the existing device without requiring complete replacement. This may involve addressing blockages, leaks, infections, or other malfunctions. The catheter's tip must terminate in a central vein like the subclavian, brachiocephalic, iliac, superior or inferior vena cava, or right atrium.
Example 1: A patient with a tunneled catheter and subcutaneous port for chemotherapy experiences difficulty flushing the port. The physician accesses the port, diagnoses a fibrin sheath, and uses thrombolytic therapy to clear the obstruction., A patient's implanted port has become dislodged from its subcutaneous pocket. The physician surgically repositions and secures the port without replacing the catheter., A patient with a peripherally inserted central catheter (PICC) and attached subcutaneous pump reports pain and swelling at the insertion site. The physician finds inflammation around the catheter and performs a repair to address the issue and ensure continued function of the CVAD.
Documentation should include the type and location of the CVAD, the reason for repair, the specific repair performed (e.g., declotting, repositioning), confirmation of device functionality post-repair, and any complications encountered.
** As of December 1st, 2024, the information provided reflects the current CPT coding guidelines and Medicare payment policies. It's essential to verify coding and reimbursement information with individual payers. Always consult the most up-to-date resources for any changes or updates to coding guidelines and fee schedules.
- Revenue Code: 5182
- RVU: 10.22 (Non-Facility), 5.43 (Facility) (As per 2024 Medicare Physician Fee Schedule)
- Global Days : Included in procedure
- Payment Status: Active
- Modifier TC rule: No TC modifier applies as this is a surgical procedure encompassing both the technical and professional components.
- Fee Schedule : Refer to historical Medicare Physician Fee Schedules for past payment information.
- Specialties:Interventional Radiology, Vascular Surgery, Cardiology, Oncology, General Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center, Physician's Office