How To Use CPT Code 36566

CPT 36566 describes the insertion of a tunneled centrally inserted central venous access device with subcutaneous port(s) using two catheters via two separate venous access sites. 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 36566?

CPT 36566 can be used to describe the insertion of a tunneled centrally inserted central venous access device with subcutaneous port(s) using two catheters via two separate venous access sites. This code is used when a physician inserts the device beneath the skin to draw blood or administer medication and nutrients to the patient. The procedure involves creating two separate incisions in the groove of the deltopectoral muscle and isolating the target vein. A double-lumen catheter is then inserted in the central vein and tunneled through the chest wall. Two separate incisions are made to create pockets, and ports are inserted and sutured in the pockets. The catheter is tied up, and the incision sites are closed.

2. Official Description

The official description of CPT code 36566 is: ‘Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; with subcutaneous port(s).’ There are no additional notes provided for this code.

3. Procedure

1. The physician administers anesthesia to the patient.
2. Two separate incisions are made in the groove of the deltopectoral muscle.
3. The target vein is isolated.
4. A double-lumen catheter is inserted in the central vein.
5. The catheter is tunneled through the chest wall.
6. Two separate incisions are made, and pockets are created.
7. Ports are inserted and connected separately to the catheters.
8. The ports are sutured in the pockets.
9. The catheter is tied up.
10. The incision sites are closed.

4. Qualifying circumstances

CPT 36566 is used when a tunneled centrally inserted central venous access device with subcutaneous port(s) is inserted using two catheters via two separate venous access sites. This procedure is typically performed when the tip of the device must terminate in the brachiocephalic (innominate) or iliac vein, subclavian vein, superior or inferior vena cava, or the right atrium. It is important to note that the physician must document the specific qualifying circumstances in the medical record to support the use of this code.

5. When to use CPT code 36566

CPT code 36566 should be used when a physician performs the insertion of a tunneled centrally inserted central venous access device with subcutaneous port(s) using two catheters via two separate venous access sites. This code should not be used for other types of central venous access device insertions or when a different number of catheters or access sites are involved.

6. Documentation requirements

To support a claim for CPT code 36566, the physician must document the following information:

• Specific details of the procedure, including the number of catheters and access sites used
• Location of the target vein
• Incision sites and creation of pockets
• Insertion and connection of ports
• Tying up of the catheter
• Closure of the incision sites

7. Billing guidelines

When billing for CPT code 36566, ensure that the procedure meets the requirements specified in the code description. It is important to note that fluoroscopic guidance or other imaging techniques may be billed separately. Avoid using brand names or incomplete documentation when coding for catheter placement. Additionally, consider the proper use of other catheter-related codes based on the specific procedure performed.

8. Historical information

CPT code 36566 was added to the Current Procedural Terminology system on January 1, 2004. The code description was later revised on January 1, 2010 to include the requirement of two catheters via two separate venous access sites.

9. Examples

1. A physician inserts a tunneled centrally inserted central venous access device with subcutaneous port(s) using two catheters via two separate venous access sites for a patient requiring long-term intravenous medication administration.
2. A surgeon performs the insertion of a tunneled centrally inserted central venous access device with subcutaneous port(s) using two catheters via two separate venous access sites for a patient undergoing chemotherapy.
3. A physician inserts a tunneled centrally inserted central venous access device with subcutaneous port(s) using two catheters via two separate venous access sites for a patient in need of frequent blood transfusions.
4. A surgeon performs the insertion of a tunneled centrally inserted central venous access device with subcutaneous port(s) using two catheters via two separate venous access sites for a patient requiring total parenteral nutrition.
5. A physician inserts a tunneled centrally inserted central venous access device with subcutaneous port(s) using two catheters via two separate venous access sites for a patient undergoing hemodialysis.
6. A surgeon performs the insertion of a tunneled centrally inserted central venous access device with subcutaneous port(s) using two catheters via two separate venous access sites for a patient in need of frequent blood draws.
7. A physician inserts a tunneled centrally inserted central venous access device with subcutaneous port(s) using two catheters via two separate venous access sites for a patient requiring long-term antibiotic therapy.