How To Use CPT Code 36510

CPT 36510 describes the catheterization of the umbilical vein in a newborn for diagnostic or therapeutic purposes. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 36510?

CPT 36510 can be used to describe the placement of a catheter into the umbilical vein of a critically ill newborn. This procedure is performed to administer intravenous fluids or medication to save the infant’s life. While peripheral access is preferred, the umbilical vein can remain a viable conduit for up to a week after birth to deliver intravenous fluids or medication.

2. Official Description

The official description of CPT code 36510 is: ‘Catheterization of umbilical vein for diagnosis or therapy, newborn.’

3. Procedure

1. The provider places the critically ill newborn under a radiant warmer and connects them to a cardiac monitor.
2. The provider sterilizes and drapes the umbilical cord stump.
3. A suture is tied around the base of the cord, and the provider uses a scalpel to cut the cord.
4. The provider identifies a vein and inserts a catheter into the umbilical vein.
5. Radiological supervision is used to confirm the positioning of the catheter.

4. Qualifying circumstances

CPT 36510 is performed on critically ill newborns who require intravenous fluids or medication. This procedure is typically included in neonatal critical care services. However, it may be reported separately if it is not included in other hospital or prolonged services codes.

5. When to use CPT code 36510

CPT code 36510 should be used when a provider performs catheterization of the umbilical vein in a newborn for diagnostic or therapeutic purposes. It should not be reported with modifier 63. This code is used specifically for the catheterization of the umbilical vein and should not be used for other venous catheterization procedures.

6. Documentation requirements

To support a claim for CPT 36510, the provider must document the following information:

• Reason for performing the procedure
• Details of the procedure, including the use of radiological supervision
• Date and time of the procedure
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 36510, ensure that the procedure is performed on a newborn and is necessary for diagnosis or therapy. It should not be reported with modifier 63. It is important to review the specific guidelines of the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 36510 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A provider places a catheter into the umbilical vein of a critically ill newborn to administer life-saving medication.
2. A newborn requires intravenous fluids, and the provider performs umbilical vein catheterization to deliver the fluids.
3. A provider uses umbilical vein catheterization to administer medication to a newborn with a severe infection.
4. A critically ill newborn needs continuous monitoring, and the provider performs umbilical vein catheterization to connect them to a cardiac monitor.
5. A provider performs umbilical vein catheterization to deliver nutrition to a newborn who is unable to feed orally.
6. A newborn requires frequent blood tests, and the provider performs umbilical vein catheterization to obtain blood samples.
7. A provider performs umbilical vein catheterization to deliver oxygen to a newborn with respiratory distress.
8. A critically ill newborn requires multiple medications, and the provider performs umbilical vein catheterization to administer the medications simultaneously.
9. A provider performs umbilical vein catheterization to deliver a contrast agent for a diagnostic imaging procedure in a newborn.
10. A newborn with a congenital heart defect requires continuous medication, and the provider performs umbilical vein catheterization to administer the medication.