How To Use CPT Code 36591

CPT 36591 refers to the collection of blood specimen from a completely implantable venous access device, and this article will cover its description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT 36591?

CPT 36591 is a medical billing code used to describe the procedure of collecting a blood specimen from a completely implantable venous access device. This code is used by medical coders and billers to accurately document and bill for this specific procedure, ensuring that healthcare providers are reimbursed for their services.

2. 36591 CPT code description

The official description of CPT code 36591 is: “Collection of blood specimen from a completely implantable venous access device.”

3. Procedure

1. The patient is appropriately prepped for the procedure.
2. The provider applies a liquid antiseptic to the area where the venous access device is located.
3. A needle is inserted through the skin into the port or reservoir of the venous access device.
4. The provider withdraws a blood sample using the needle.
5. The port is flushed with a heparin solution to prevent clot formation.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 36591 services are those who have a completely implantable venous access device in place, which was placed during a prior procedure. This device is typically used for patients who require long-term intravenous therapy or frequent blood draws, such as those undergoing chemotherapy or receiving parenteral nutrition. The device allows for easier and less painful access to the patient’s bloodstream, reducing the need for repeated needle sticks.

5. When to use CPT code 36591

It is appropriate to bill the 36591 CPT code when a healthcare provider collects a blood specimen from a completely implantable venous access device that was placed in a prior procedure. This code should not be used for blood collection from an established central or peripheral catheter, as a different code (36592) applies to those situations.

6. Documentation requirements

To support a claim for CPT 36591, the following information should be documented in the patient’s medical record:

• Patient’s medical history and the reason for the blood draw
• Date and time of the procedure
• Location of the venous access device
• Details of the blood collection procedure, including the use of antiseptic and heparin flush
• Any complications or adverse reactions experienced by the patient during the procedure

7. Billing guidelines

When billing for CPT code 36591, it is important to follow the appropriate guidelines and rules to ensure accurate reimbursement. Some key points to consider include:

• Do not report CPT 36591 in conjunction with other services except a laboratory service.
• For collection of venous blood specimen by venipuncture, use CPT code 36415.
• For collection of capillary blood specimen, use CPT code 36416.

8. Historical information

CPT 36591 was added to the Current Procedural Terminology system on January 1, 2008. There have been no updates to the code since its addition.

9. Similar codes to CPT 36591

Five similar codes to CPT 36591 and how they differentiate from it are:

1. CPT 36592: Collection of blood specimen using an established central or peripheral catheter, rather than a completely implantable venous access device.
2. CPT 36415: Collection of venous blood specimen by venipuncture, which involves inserting a needle directly into a vein to collect blood.
3. CPT 36416: Collection of capillary blood specimen, typically done by pricking the skin (e.g., fingerstick) to obtain a small amount of blood.
4. CPT 36555: Insertion of a non-tunneled centrally inserted central venous catheter, which is a different type of venous access device than the one used in CPT 36591.
5. CPT 36556: Insertion of a tunneled centrally inserted central venous catheter, another type of venous access device that differs from the one used in CPT 36591.

10. Examples

Here are 10 detailed examples of CPT code 36591 procedures:

1. A patient with a completely implantable venous access device requires a blood draw for routine laboratory testing.
2. A patient undergoing chemotherapy has a blood sample collected from their completely implantable venous access device to monitor their response to treatment.
3. A patient receiving parenteral nutrition has a blood sample collected from their completely implantable venous access device to assess their nutritional status.
4. A patient with a completely implantable venous access device has a blood draw to monitor their blood clotting factors.
5. A patient with a completely implantable venous access device requires a blood draw to check their electrolyte levels.
6. A patient with a completely implantable venous access device has a blood sample collected to monitor their kidney function.
7. A patient with a completely implantable venous access device requires a blood draw to assess their liver function.
8. A patient with a completely implantable venous access device has a blood sample collected to monitor their blood glucose levels.
9. A patient with a completely implantable venous access device requires a blood draw for a complete blood count (CBC) test.
10. A patient with a completely implantable venous access device has a blood sample collected to check their medication levels.