2025 CPT code 36581
(Active) Effective Date: N/A Revision Date: N/A Surgery - Cardiovascular System Procedures Surgery Feed
Complete replacement of a tunneled central venous catheter without a port or pump through the same venous access site.
Modifiers may be applicable depending on the circumstances of the procedure.For example, modifier 51 (multiple procedures) may be used if other procedures were performed.Consult the current CPT coding guidelines for appropriate modifier usage.
Medical necessity for the replacement of a central venous catheter must be supported by clinical documentation.Reasons may include malfunction, catheter occlusion, infection, or the need for a different type of catheter.Documentation should clearly demonstrate the need for replacement and justify the medical necessity of the procedure.
The physician is responsible for all aspects of the procedure, including patient assessment, catheter removal, insertion of the new catheter, securing the catheter, hemostasis, and wound closure.This may include pre- and post-procedure care as well.Use of imaging guidance may be separately coded when appropriate.
In simple words: This code covers replacing a long-term intravenous (IV) tube (catheter) already placed under the skin. The doctor removes the old tube and puts in a new one using the same entry point. This avoids creating a new opening in the body.
This CPT code encompasses the complete replacement of a tunneled, centrally inserted central venous access catheter without a subcutaneous port or pump.The procedure involves removing the existing catheter and inserting a new one through the same venous access site.The code includes all necessary steps, from removal of the old catheter to insertion of the new one, securing the new catheter, and closure of the access site.It does not include separate coding for removal of the old catheter or imaging guidance.
Example 1: A patient with a tunneled central venous catheter experiencing clotting requires a complete catheter replacement. The physician removes the existing catheter and inserts a new one through the same venous access site. Code 36581 is appropriate., A patient's tunneled central venous catheter is damaged, requiring replacement.The physician replaces the catheter through the existing access site. Code 36581 accurately reflects the procedure., A patient needs their tunneled central venous catheter replaced due to malfunction. The physician removes the old catheter and inserts a new one through the same access point. Code 36581 is the correct code.
Complete medical record documentation is required, including the indication for replacement (e.g., malfunction, occlusion, infection), description of the procedure performed, confirmation of access site used, and post-procedure assessment.Imaging studies (if performed) should also be documented.
** The use of imaging guidance (e.g., fluoroscopy) is not included in this code and should be separately coded if used (with appropriate modifiers if necessary).Any additional procedures, such as removal of obstructive material or fibrin sheath, should be coded separately.Always consult the most current CPT manual and relevant guidelines for accurate coding.
- RVU: The relative value units (RVUs) for this code are subject to change based on the Medicare Physician Fee Schedule and location.Consult the current MPFS for the most up-to-date RVU values.
- Global Days : The global period for this procedure is typically included within the code itself.No additional days are typically billed.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not typically applicable to this code, as the procedure is usually performed entirely by the physician.
- Fee Schedule : Historical fee schedule information can be found in the archives of the Medicare Physician Fee Schedule (MPFS).These values are subject to change and may vary based on location.
- Specialties:Vascular Surgery, Interventional Radiology, Oncology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center