How To Use CPT Code 36556

CPT 36556 refers to the insertion of a non-tunneled centrally inserted central venous catheter in patients aged 5 years or older. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 36556 procedures.

1. What is CPT 36556?

CPT 36556 is a medical procedure code used to describe the insertion of a non-tunneled centrally inserted central venous catheter in patients aged 5 years or older. This type of catheter is used for drawing blood or administering medication or nutrients to the patient. The code is used by medical professionals to accurately document and bill for this specific procedure.

2. 36556 CPT code description

The official description of CPT code 36556 is: “Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older.”

3. Procedure

The 36556 procedure involves the following steps:

  1. Administration of local anesthesia to the patient.
  2. Percutaneous insertion of a needle into the jugular, subclavian, or femoral vein, sometimes under fluoroscopic guidance.
  3. Insertion of the central venous access catheter through the needle.
  4. Positioning of the catheter tip in the appropriate location, such as the brachiocephalic (innominate) or iliac vein, subclavian, the superior or inferior vena cava, or the right atrium.
  5. Securing the catheter on the skin surface with tape to prevent accidental movement or removal.

4. Qualifying circumstances

Patients eligible to receive CPT code 36556 services are those aged 5 years or older who require a non-tunneled centrally inserted central venous catheter for the purpose of drawing blood or administering medication or nutrients. This type of catheter is typically used for short-term treatment, lasting up to 2-3 weeks.

5. When to use CPT code 36556

It is appropriate to bill the 36556 CPT code when a non-tunneled centrally inserted central venous catheter is inserted in a patient aged 5 years or older for the purpose of drawing blood or administering medication or nutrients. The procedure should be performed by a qualified healthcare provider and documented accurately in the patient’s medical record.

6. Documentation requirements

To support a claim for CPT 36556, the following information should be documented in the patient’s medical record:

  • Patient’s age and medical necessity for the procedure.
  • Details of the procedure, including the type of catheter used, the insertion site, and the positioning of the catheter tip.
  • Use of any imaging guidance, such as fluoroscopy or ultrasound, during the procedure.
  • Any complications or additional interventions required during the procedure.
  • Post-procedure care instructions and follow-up plan.

7. Billing guidelines

When billing for CPT code 36556, it is important to follow the appropriate guidelines and rules. Some tips and codes that apply to CPT code 36556 include:

  • For the same procedure in a patient younger than 5 years of age, use CPT code 36555.
  • If fluoroscopic guidance is used, report add-on code +77001 in addition to the primary procedure code.
  • If ultrasound guidance is used, report add-on code +76937 in addition to the primary procedure code.
  • Ensure that the documentation accurately reflects the procedure performed and supports the use of CPT code 36556.

8. Historical information

CPT 36556 was added to the Current Procedural Terminology system on January 1, 2004. There have been no updates to the code since its addition.

9. Similar codes to CPT 36556

Five similar codes to CPT 36556 and how they differentiate from CPT 36556 are:

  • CPT 36555: Insertion of a non-tunneled centrally inserted central venous catheter in patients younger than 5 years of age.
  • CPT 36557: Insertion of a tunneled centrally inserted central venous catheter without a subcutaneous port or pump in patients younger than 5 years old.
  • CPT 36558: Insertion of a tunneled centrally inserted central venous catheter without a subcutaneous port or pump in patients aged 5 years or older.
  • CPT 36568: Insertion of a peripherally inserted central venous catheter (PICC) without imaging guidance and without subcutaneous port or pump in patients younger than 5 years of age.
  • CPT 36569: Insertion of a peripherally inserted central venous catheter (PICC) without imaging guidance and without subcutaneous port or pump in patients aged 5 years or older.

10. Examples

Here are 10 detailed examples of CPT code 36556 procedures:

  1. A 6-year-old patient requiring a non-tunneled central venous catheter for intravenous antibiotic administration.
  2. A 12-year-old patient with a severe infection requiring a non-tunneled central venous catheter for blood draws and medication administration.
  3. An 8-year-old patient with dehydration requiring a non-tunneled central venous catheter for fluid administration.
  4. A 15-year-old patient with a chronic illness requiring a non-tunneled central venous catheter for short-term medication administration.
  5. A 10-year-old patient with a complex medical condition requiring a non-tunneled central venous catheter for blood draws and medication administration.
  6. A 7-year-old patient with a severe allergic reaction requiring a non-tunneled central venous catheter for medication administration.
  7. A 9-year-old patient with a blood disorder requiring a non-tunneled central venous catheter for blood transfusions.
  8. An 11-year-old patient with a gastrointestinal disorder requiring a non-tunneled central venous catheter for nutritional support.
  9. A 13-year-old patient with a severe burn injury requiring a non-tunneled central venous catheter for fluid and medication administration.
  10. A 16-year-old patient with a complex medical condition requiring a non-tunneled central venous catheter for blood draws, medication administration, and nutritional support.

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