How To Use CPT Code 36555

CPT 36555 describes the insertion of a non-tunneled centrally inserted central venous catheter in patients younger than 5 years of age. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 36555?

CPT 36555 can be used to describe the insertion of a central venous access catheter in the neck, chest, or groin of patients who are younger than 5 years of age. This procedure is performed to draw blood or administer medication or nutrients to the patient.

2. Official Description

The official description of CPT code 36555 is: ‘Insertion of non-tunneled centrally inserted central venous catheter; younger than 5 years of age.’

3. Procedure

1. The provider administers local anesthesia to the patient.
2. A needle is percutaneously inserted into the jugular, subclavian, or femoral vein, and sometimes into the inferior vena cava under fluoroscopic guidance.
3. The catheter’s tip is positioned in the brachiocephalic (innominate) or iliac vein, subclavian, the superior or inferior vena cava, or the right atrium.
4. Part of the catheter is left on top of the skin and secured to prevent movement or accidental removal.

4. Qualifying circumstances

CPT 36555 is used for patients who are younger than 5 years of age and require the insertion of a non-tunneled centrally inserted central venous catheter for the administration of medication, nutrients, or blood drawing. The catheter’s tip must terminate in specific veins or chambers of the heart.

5. When to use CPT code 36555

CPT code 36555 should be used when a provider inserts a non-tunneled centrally inserted central venous catheter in a patient who is younger than 5 years of age. This code is appropriate for procedures involving the jugular, subclavian, or femoral veins, and sometimes the inferior vena cava. If the patient is 5 years of age or older, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT 36555, the provider must document the following information:

• Patient’s age
• Location of the catheter insertion
• Specific veins or chambers where the catheter’s tip terminates
• Procedure details, including the use of local anesthesia and fluoroscopic guidance
• Any additional relevant information or complications

7. Billing guidelines

When billing for CPT 36555, ensure that the patient is younger than 5 years of age and that the procedure involves the insertion of a non-tunneled centrally inserted central venous catheter. Follow any additional guidelines provided by the payer or coding guidelines. It is important to accurately report the procedure to ensure proper reimbursement.

8. Historical information

CPT 36555 was added to the Current Procedural Terminology system on January 1, 2004. There was a code change on January 1, 2007, which updated the description to specify patients younger than 5 years of age.

9. Examples

1. A provider inserts a non-tunneled centrally inserted central venous catheter in the neck of a 3-year-old patient to administer medication.
2. A provider inserts a non-tunneled centrally inserted central venous catheter in the chest of a 2-year-old patient for blood drawing purposes.
3. A provider inserts a non-tunneled centrally inserted central venous catheter in the groin of a 4-year-old patient to administer nutrients.
4. A provider inserts a non-tunneled centrally inserted central venous catheter in the jugular vein of a 1-year-old patient for medication administration.
5. A provider inserts a non-tunneled centrally inserted central venous catheter in the femoral vein of a 5-month-old patient for blood drawing purposes.
6. A provider inserts a non-tunneled centrally inserted central venous catheter in the subclavian vein of a 6-month-old patient to administer medication.
7. A provider inserts a non-tunneled centrally inserted central venous catheter in the inferior vena cava of a 4-year-old patient for blood drawing purposes.
8. A provider inserts a non-tunneled centrally inserted central venous catheter in the brachiocephalic vein of a 3-year-old patient to administer nutrients.
9. A provider inserts a non-tunneled centrally inserted central venous catheter in the superior vena cava of a 2-year-old patient for medication administration.
10. A provider inserts a non-tunneled centrally inserted central venous catheter in the right atrium of a 1-year-old patient for blood drawing purposes.