How To Use CPT Code 36572

CPT 36572 describes the insertion of a peripherally inserted central venous catheter (PICC) in patients younger than five years of age. 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 36572?

CPT 36572 is used to describe the insertion of a peripherally inserted central venous catheter (PICC) in patients who are younger than five years of age. This code covers the placement of the catheter without the use of a subcutaneous port or pump, and includes all imaging guidance, image documentation, and radiological supervision and interpretation required for the procedure.

2. Official Description

The official description of CPT code 36572 is: ‘Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the insertion; younger than 5 years of age.’

3. Procedure

1. The provider prepares the patient, who is younger than five years of age, and ensures they are appropriately prepped and sedated.
2. The patient lies on a table in a radiology interventional procedure room, with their arm resting on an arm board for support.
3. The provider places a tourniquet around the patient’s arm just below the shoulder.
4. Under imaging guidance, the provider selects a vein for PICC access and injects a local anesthetic, such as 1% lidocaine, into the skin.
5. Still using imaging guidance, the provider inserts a thin needle into the selected vein and advances a guidewire through the needle into the vein.
6. The provider removes the needle and advances a catheter over the guidewire to the superior vena cava, inferior vena cava, or the proximal right atrium.
7. The provider tests the catheter for blood return and flushes it with sterile normal saline.
8. A cap is placed over the hub of the catheter, and the provider confirms the position of the catheter tip using imaging guidance or a chest X-ray.
9. The entry site of the catheter is secured with sutures, and the insertion site is cleaned and dressed with sterile gauze and an adhesive dressing.

4. Qualifying circumstances

CPT 36572 is used for the insertion of a peripherally inserted central venous catheter (PICC) in patients younger than five years of age. This code specifically covers the placement of the catheter without the use of a subcutaneous port or pump. The procedure must include all imaging guidance, image documentation, and radiological supervision and interpretation required for the insertion.

5. When to use CPT code 36572

CPT code 36572 should be used when a provider inserts a peripherally inserted central venous catheter (PICC) in a patient who is younger than five years of age. This code is appropriate when the procedure does not involve the placement of a subcutaneous port or pump, and includes all necessary imaging guidance, image documentation, and radiological supervision and interpretation.

6. Documentation requirements

To support a claim for CPT code 36572, the provider must document the following information:

• Patient’s age and the need for a peripherally inserted central venous catheter (PICC)
• Specific details of the procedure, including the use of imaging guidance and any complications encountered
• Date and duration of the procedure
• Imaging documentation, including any images obtained during the procedure
• Radiological supervision and interpretation
• Confirmation of the catheter tip position
• Details of any additional procedures performed during the same session
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 36572, ensure that the procedure meets the specific criteria outlined in the code description. The patient must be younger than five years of age, and the procedure must involve the insertion of a peripherally inserted central venous catheter (PICC) without the use of a subcutaneous port or pump. All necessary imaging guidance, image documentation, and radiological supervision and interpretation must be included. It is important to follow any additional guidelines or requirements set forth by the payer or coding guidelines.

8. Historical information

CPT code 36572 was added to the Current Procedural Terminology system on January 1, 2019. There have been no updates or changes to the code since its addition.

9. Examples

1. A radiologist inserts a peripherally inserted central venous catheter (PICC) in a four-year-old patient, using imaging guidance and documenting all necessary images and radiological supervision and interpretation.