2025 CPT code 36861
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
External cannula declotting (separate procedure); with balloon catheter.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., 51 for multiple procedures, 59 for distinct procedural service, etc.). Consult the most current CPT guidelines for modifier usage.
Medical necessity for this procedure is established when a clot obstructs the flow through an existing cannula, compromising the delivery of treatment (e.g., dialysis, medication administration) or causing potential complications. Documentation should demonstrate the need to restore cannula patency to prevent complications like infection or compromised patient care.
The physician is responsible for the preparation of the patient, administering anesthesia (if applicable), removing the clot using the balloon catheter technique, and ensuring the cannula remains in place post-procedure.
In simple words: The doctor removes a blood clot from a tube (cannula) already placed in the body, using a special balloon-tipped catheter.They may use medicine to help break down the clot first. The balloon is inflated to catch the clot, and then the catheter is pulled out, bringing the clot with it.
This procedure involves the removal of a clot from an externally placed cannula using a balloon catheter.The provider may pre-treat the cannula with an anticoagulant or thrombolytic agent before inserting the balloon catheter. The catheter is advanced beyond the clot, the balloon inflated, and then the catheter is slowly withdrawn, removing the clot.Once the clot is removed, the catheter is withdrawn, leaving the cannula in place.If imaging guidance is used, code 76000 should also be billed.
Example 1: A patient presents with a clot obstructing a hemodialysis cannula. The physician uses a balloon catheter to remove the clot, restoring patency., A patient with an indwelling central venous catheter develops a clot at the catheter tip.The physician utilizes a balloon catheter to clear the obstruction., A patient post-surgical procedure with a temporary arterial line experiences clot formation. A balloon catheter is employed for clot removal, maintaining the integrity of the arterial line.
* Pre-procedure assessment and patient history.* Description of the cannula type and location.* Documentation of the clot's characteristics (size, location, consistency).* Details of any pre-treatment medication (anticoagulant or thrombolytic) administered.* Description of the procedure, including balloon catheter size and inflation pressure.* Confirmation of clot removal and restoration of cannula patency.* Post-procedure assessment and patient's condition.* If imaging guidance is used, the appropriate imaging reports should be documented.
** Always refer to the most current CPT and NCCI guidelines for accurate coding and billing practices.Documentation must clearly support the medical necessity and justify the use of this code.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Vascular Surgery, Interventional Cardiology, Nephrology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center