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2025 HCPCS code S5522

Nursing services for insertion of a peripherally inserted central venous catheter (PICC) for home infusion therapy. This code does not include supplies or the catheter itself.

This code is for the nursing services only and should not be reported in conjunction with codes for the supplies or the catheter itself (S5520).It is important to ensure that the documentation supports the medical necessity of the PICC line insertion and home infusion therapy.

Medical necessity for PICC line insertion for home infusion therapy must be clearly documented. This generally includes a diagnosis requiring long-term intravenous therapy, the specific therapy being administered, the duration of therapy, and why alternative methods of administration are not appropriate or feasible.

The qualified healthcare professional (typically a registered nurse) is responsible for inserting the PICC line, ensuring proper placement and patient safety during the procedure.This includes assessing the patient’s veins, preparing the insertion site, inserting the catheter, and confirming proper placement.

IMPORTANT:For the supplies and catheter used in PICC insertion, use S5520. For midline catheter insertion nursing services, use S5523.For midline catheter insertion supplies, use S5521. For nursing visits related to home infusion (up to two hours), use CPT code 99601. For each additional hour beyond the initial two, use CPT code 99602.

In simple words: This code covers the nurse's work to put in a PICC line, which is a small tube placed in a vein for long-term medicine or fluid delivery at home.It doesn't include the cost of the supplies or the tube itself.

Home infusion therapy, insertion of peripherally inserted central venous catheter (PICC), nursing services only (no supplies or catheter included). This code covers the skilled nursing services associated with inserting a PICC line for home infusion therapy. It does not include the cost of the catheter, supplies, or any other services related to the infusion therapy itself.

Example 1: A patient with a chronic illness requiring long-term intravenous medication is at home and needs a PICC line inserted for safe and effective drug administration., A patient receiving total parenteral nutrition (TPN) at home requires a new PICC line placement., A patient undergoing long-term antibiotic treatment at home needs a PICC line inserted to avoid repeated venipunctures.

Documentation should include the date and time of insertion, site of insertion, type and size of catheter used, confirmation of placement (e.g., chest x-ray), and any complications encountered during the procedure. The medical necessity for home infusion and PICC line placement should also be documented, including the diagnosis, treatment plan, and the reason why alternative venous access methods are not suitable.

** This code is specific to the insertion of a PICC line and does not include other nursing services related to home infusion therapy, such as administering medications, monitoring the patient, or providing patient education.

  • Payment Status: Active
  • Specialties:Home Health, Infusion Therapy, Vascular Access
  • Place of Service:Home, Office, Ambulatory Surgical Center
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