2025 CPT code 36578
(Active) Effective Date: N/A Surgery - Cardiovascular System Surgery Feed
Partial replacement of the catheter component of a central venous access device with a subcutaneous port or pump, at a central or peripheral insertion site.
Modifiers may be applicable in certain circumstances. For example, modifier 76 may be used for a repeat procedure by the same physician, or modifier 77 if performed by a different physician.
Medical necessity for this procedure must be documented. This typically involves demonstrating that the existing catheter is no longer functional due to blockage, damage, or other issues, and that continued venous access is required for ongoing therapy (e.g., chemotherapy, long-term antibiotics, pain management).
A physician, typically a surgeon, interventional radiologist, or other specialist trained in vascular access, performs the procedure. It involves accessing the existing port or pump, removing the old catheter, and inserting a new one through the same venous access site, connecting it to the port/pump.
In simple words: This procedure involves replacing the tube part of a long-term IV line that has a port or pump under the skin. The port or pump itself is not replaced. This is done if the tube is blocked or damaged.
This code describes the replacement of only the catheter portion of a central venous access device (CVAD) that has a subcutaneous port or pump. This procedure is typically performed when the catheter is malfunctioning (e.g., blocked, damaged) but the port or pump is still functional. The existing port or pump is not replaced.The catheter may have been initially inserted at a central or peripheral location.
Example 1: A patient with a tunneled catheter and subcutaneous port for chemotherapy develops a catheter occlusion. The physician replaces the catheter, leaving the port in place., A patient with a peripherally inserted central catheter (PICC) line and attached pump for long-term antibiotic therapy experiences catheter damage. The physician replaces the PICC line, maintaining the pump., A patient's implanted port catheter for pain medication becomes fractured.The physician replaces the catheter portion only.
Documentation should include the reason for catheter replacement (e.g., occlusion, damage), the type of existing CVAD (tunneled, PICC, implanted port), the location of the insertion site, the method of catheter insertion, and any complications encountered.
- Specialties:Interventional Radiology, Vascular Surgery, General Surgery, Oncology, Critical Care
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center, Physician's Office, Other Place of Service