How To Use CPT Code 36569

CPT 36569 refers to the insertion of a peripherally inserted central venous catheter (PICC) without subcutaneous port or pump, without imaging guidance, for 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 36569 procedures.

1. What is CPT 36569?

CPT 36569 is a medical procedure code used to describe the insertion of a peripherally inserted central venous catheter (PICC) without a subcutaneous port or pump and without imaging guidance for patients aged 5 years or older. This procedure is performed to administer medications or fluids directly into the bloodstream, providing a more efficient and less invasive method of treatment for various medical conditions.

2. 36569 CPT code description

The official description of CPT code 36569 is: “Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, without imaging guidance; age 5 years or older.”

3. Procedure

The 36569 procedure involves the following steps:

  1. The patient is appropriately prepped and anesthetized.
  2. The provider locates the basilic or cephalic vein in the upper extremity of the patient.
  3. The tip of the catheter is inserted through the skin, and a guidewire is inserted.
  4. The provider guides the catheter over the guidewire into one of the target veins, such as the brachiocephalic, innominate, iliac vein, subclavian, superior or inferior vena cava, or directly into the right atrium of the heart.
  5. After placing the catheter, the guidewire is withdrawn, bleeding is controlled, and the insertion site is irrigated with antibiotics.

4. Qualifying circumstances

Patients eligible to receive CPT code 36569 services are those aged 5 years or older who require the insertion of a PICC for the administration of medications or fluids directly into the bloodstream. This procedure is typically performed when other methods of treatment are not suitable or less effective, such as oral medications or peripheral intravenous lines.

5. When to use CPT code 36569

It is appropriate to bill the 36569 CPT code when the following conditions are met:

  • The patient is aged 5 years or older.
  • The procedure involves the insertion of a PICC without a subcutaneous port or pump.
  • Imaging guidance is not used during the procedure.
  • The purpose of the procedure is to administer medications or fluids directly into the bloodstream.

6. Documentation requirements

To support a claim for CPT 36569, the following information should be documented:

  • Patient’s age and medical condition requiring the PICC insertion.
  • Details of the procedure, including the vein used for insertion, target vein, and absence of subcutaneous port or pump.
  • Confirmation that imaging guidance was not used during the procedure.
  • Details of any complications or additional procedures performed during the PICC insertion.

7. Billing guidelines

When billing for CPT code 36569, it is essential to follow the appropriate guidelines and rules. Some tips and codes that apply to CPT code 36569 include:

  • Do not report CPT 36569 in conjunction with 76937 or 77001.
  • For placement of centrally inserted non-tunneled central venous catheter, without subcutaneous port or pump, age 5 years or older, use CPT 36556.
  • For placement of peripherally inserted non-tunneled central venous catheter, without subcutaneous port or pump, with imaging guidance, age 5 years or older, use CPT 36573.

8. Historical information

CPT 36569 was added to the Current Procedural Terminology system on January 1, 2004. The code was changed on January 1, 2019, with the previous descriptor being “Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump; age 5 years or older.”

9. Similar codes to CPT 36569

Five similar codes to CPT 36569 and how they differentiate from CPT 36569 are:

  1. CPT 36568: This code is used for the same procedure as CPT 36569 but for patients younger than 5 years of age.
  2. CPT 36572: This code is used for PICC line insertion without subcutaneous port or pump but with imaging guidance and all RS&I on a patient younger than 5 years of age.
  3. CPT 36573: This code is used for the same procedure as CPT 36572 but for patients aged 5 years or older.
  4. CPT 36556: This code is used for the placement of centrally inserted non-tunneled central venous catheter, without subcutaneous port or pump, age 5 years or older.
  5. CPT 36555-36598: This code range includes other codes for central venous access device procedures, with the choice of code based on the type of device inserted and the patient’s age.

10. Examples

Here are 10 detailed examples of CPT code 36569 procedures:

  1. A 6-year-old patient with a severe infection requiring intravenous antibiotics receives a PICC insertion without imaging guidance.
  2. A 12-year-old patient with cystic fibrosis requires a PICC for long-term administration of medications without imaging guidance.
  3. An 8-year-old patient with cancer needs a PICC for chemotherapy administration without imaging guidance.
  4. A 15-year-old patient with a gastrointestinal disorder requires a PICC for total parenteral nutrition administration without imaging guidance.
  5. A 10-year-old patient with a chronic illness needs a PICC for long-term medication administration without imaging guidance.
  6. A 7-year-old patient with a severe allergic reaction requires a PICC for emergency medication administration without imaging guidance.
  7. An 11-year-old patient with a blood clotting disorder needs a PICC for blood product administration without imaging guidance.
  8. A 9-year-old patient with a severe burn injury requires a PICC for fluid resuscitation without imaging guidance.
  9. A 14-year-old patient with a kidney disorder needs a PICC for dialysis treatment without imaging guidance.
  10. A 5-year-old patient with a rare genetic disorder requires a PICC for specialized medication administration without imaging guidance.

Similar Posts

Leave a Reply

Your email address will not be published. Required fields are marked *