2025 CPT code 36583

Complete replacement of a tunneled central venous access device with a subcutaneous pump, through the same venous access site.

Follow all applicable CPT coding guidelines and the guidelines specified in the AMA CPT manual.Accurate documentation is critical for proper reimbursement.

Modifiers may be applicable depending on the circumstances of the procedure.For instance, modifier 58 may be used if this is a staged procedure related to a previous procedure. Modifier 22 may be used if the procedure was significantly more complex than usual.Consult the current CPT guidelines for a complete list of applicable modifiers and their appropriate usage.

The medical necessity for this procedure is established when the existing tunneled CVAD with pump is malfunctioning, infected, or no longer suitable for continued use, and replacement is required to maintain adequate venous access for medication delivery, nutrition, or blood draws.Documentation should support the need for replacement and justify the clinical decision.

The physician is responsible for all aspects of the procedure, including patient assessment, pre-procedure preparation, the surgical replacement of the CVAD and pump, and post-procedure monitoring.Anesthesiology services may also be involved depending on the patient's condition and the complexity of the procedure.

IMPORTANT Related codes may include those for insertion, repair, partial replacement, or removal of central venous access devices, depending on the specific circumstances.Modifiers may be necessary to accurately reflect the procedure performed.

In simple words: This code describes replacing a long-term intravenous (IV) tube and pump that's already under the skin.The old IV tube and pump are removed, and a new one is put in through the same place. This is done if the old one is broken or infected.

This CPT code, 36583, represents the complete replacement of a tunneled central venous access device (CVAD) that includes a subcutaneous pump.The replacement is performed through the same venous access site as the original device. This procedure involves removing the existing tunneled catheter and pump, and inserting a new catheter and pump through the pre-existing access site. The procedure is indicated when the existing device malfunctions, becomes infected, or is otherwise no longer suitable for continued use.The procedure includes all necessary steps, from preparation to closure of the access site.

Example 1: A patient with a tunneled central venous catheter and subcutaneous pump experiences catheter occlusion.A complete device replacement via 36583 is performed., A patient with a tunneled CVAD and pump develops a local infection at the insertion site. The device is removed, and a new device is placed through the same access site using code 36583., A patient requires long-term intravenous chemotherapy and their existing tunneled CVAD with a pump becomes damaged. The device is replaced using 36583 to ensure continued treatment.

* Thorough patient history, including indication for CVAD placement and prior catheterization attempts.* Pre-procedure imaging (e.g., ultrasound or fluoroscopy) to assess device position and surrounding anatomy.* Intra-operative documentation detailing the removal of the old device, insertion of the new device, and confirmation of placement.* Post-procedure imaging to confirm appropriate placement of the new device.* Complete blood count (CBC) and coagulation studies.* Pathology results, if applicable.

** Always refer to the most recent CPT codebook and relevant payer guidelines for the most accurate coding and reimbursement information. This information is for guidance only and does not constitute medical advice.

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