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2025 CPT code 96523

Irrigation of implanted venous access device for drug delivery systems.

96523 should only be reported when it's the sole service provided on the date of service.It should not be billed with other services.Other related codes (36591, 36593) should be used for specific procedures such as blood collection or catheter declotting.

Modifiers may be applicable depending on the circumstances of service. Consult the AMA CPT manual and payer specific guidelines for appropriate modifier usage.

Medical necessity is established when the implanted venous access device requires irrigation to maintain its patency and function for ongoing drug delivery. This prevents complications such as clotting, infection, and blockage, allowing safe and effective medication administration.

The physician or qualified healthcare professional is responsible for ensuring the proper placement and maintenance of the implanted venous access device. This includes flushing the device to prevent clotting and maintain functionality. The procedure is typically performed by a nurse under the supervision of the physician, though direct supervision may not always be required.

IMPORTANT:Do not report 96523 with other services.Use 36591 for blood specimen collection and 36593 for declotting a catheter or port.

In simple words: The doctor cleans a small tube under the skin used to give medicine. This keeps the tube working properly.

This CPT code encompasses the irrigation or flushing of an implanted venous access device utilized for drug delivery.The procedure involves using a solution, typically saline and heparin, to maintain patency of the device.This service is distinct from other procedures like collecting blood specimens or declotting catheters.

Example 1: A patient with a long-term implanted port receives routine flushing of the port to maintain its patency for future chemotherapy administration., A patient who received chemotherapy through a port undergoes a port flush to remove any residual medication and prevent clotting., A patient with an implanted venous access device requires a port flush before receiving a subsequent medication administration through the device.

Documentation should include the date of service, the type of venous access device (e.g., port-a-cath, Hickman catheter), the type and amount of solution used for irrigation, and confirmation that this was the only service provided on that date of service.

** This code is primarily used in oncology and other specialties where implanted venous access devices are utilized for medication delivery.The use of heparin in the flushing solution is standard practice, but the specific solution used should be documented.Always refer to the most current CPT manual and payer guidelines for accurate coding and reimbursement.

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