How To Use CPT Code 36563

CPT 36563 describes the insertion of a tunneled centrally inserted central venous access device with a subcutaneous pump. 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 36563?

CPT 36563 involves the insertion of a tunneled centrally inserted central venous access device with a subcutaneous pump. This procedure is performed by a physician and allows for the administration of medication and nutrients, as well as the withdrawal of blood, through a catheter that is inserted beneath the skin.

2. Official Description

The official description of CPT code 36563 is the insertion of a tunneled centrally inserted central venous access device with a subcutaneous pump. This procedure involves creating a subcutaneous tunnel and inserting a catheter into the vein near the heart. A separate incision is made to insert a titanium pump, which is connected to the catheter.

3. Procedure

1. The physician administers anesthesia to the patient.
2. An incision is made in the groove of the deltopectoral muscle to access the subclavian vein.
3. A subcutaneous tunnel is created between the vein entry and external access sites.
4. A tunneled catheter is inserted into the vein near the heart.
5. A separate incision is made, generally in the abdomen region, to create pockets for the titanium pump.
6. The titanium pump is inserted into the pockets and connected to the catheter.
7. The incisions are closed.

4. Qualifying circumstances

CPT 36563 is performed on patients who require a central venous access device for the administration of medication and nutrients. The procedure involves the insertion of a tunneled catheter into the vein near the heart, as well as the placement of a subcutaneous pump. This procedure is typically performed on patients who have conditions that require long-term intravenous therapy.

5. When to use CPT code 36563

CPT code 36563 should be used when a physician performs the insertion of a tunneled centrally inserted central venous access device with a subcutaneous pump. This code is appropriate for patients who require long-term intravenous therapy and need a central venous access device for the administration of medication and nutrients.

6. Documentation requirements

To support a claim for CPT 36563, the physician must document the following information:

• Indication for the procedure
• Details of the procedure, including the creation of a subcutaneous tunnel, insertion of the catheter, and placement of the subcutaneous pump
• Incision sites and closure
• Any complications or additional procedures performed
• Signature of the performing physician

7. Billing guidelines

When billing for CPT 36563, ensure that the procedure is performed by a physician and involves the insertion of a tunneled centrally inserted central venous access device with a subcutaneous pump. It is important to follow the specific documentation requirements and guidelines provided by the payer. Additionally, be aware of any bundling or unbundling rules that may apply to this procedure.

8. Historical information

CPT 36563 was added to the Current Procedural Terminology system on January 1, 2004. There have been no updates to the code since its addition.

9. Examples

1. A physician inserts a tunneled centrally inserted central venous access device with a subcutaneous pump for a patient requiring long-term intravenous therapy.
2. A patient with a chronic illness undergoes the insertion of a tunneled centrally inserted central venous access device with a subcutaneous pump to facilitate the administration of medication and nutrients.
3. A physician performs the insertion of a tunneled centrally inserted central venous access device with a subcutaneous pump for a patient who will require long-term intravenous therapy at home.
4. A patient undergoing chemotherapy receives the insertion of a tunneled centrally inserted central venous access device with a subcutaneous pump to facilitate the administration of medication.
5. A physician performs the insertion of a tunneled centrally inserted central venous access device with a subcutaneous pump for a patient with gastrointestinal issues who requires long-term intravenous nutrition.
6. A patient with a severe infection undergoes the insertion of a tunneled centrally inserted central venous access device with a subcutaneous pump to facilitate the administration of antibiotics.
7. A physician inserts a tunneled centrally inserted central venous access device with a subcutaneous pump for a patient who will require long-term intravenous therapy for pain management.
8. A patient with a genetic disorder receives the insertion of a tunneled centrally inserted central venous access device with a subcutaneous pump to facilitate the administration of specialized medication.
9. A physician performs the insertion of a tunneled centrally inserted central venous access device with a subcutaneous pump for a patient with kidney failure who requires long-term hemodialysis.
10. A patient undergoing a bone marrow transplant receives the insertion of a tunneled centrally inserted central venous access device with a subcutaneous pump to facilitate the administration of medication and nutrients.