How To Use CPT Code 36573

CPT 36573 describes the insertion of a peripherally inserted central venous catheter (PICC) without a subcutaneous port or pump, including all imaging guidance, image documentation, and associated radiological supervision and interpretation required for the procedure. 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 36573?

CPT 36573 is used to describe the insertion of a peripherally inserted central venous catheter (PICC) without a subcutaneous port or pump, in patients who are five years of age or older. This procedure involves placing a catheter through the basilic or cephalic vein in the arm and directing it into one of the major veins that carry blood to the heart or directly into the right atrium. The code also includes all imaging guidance, image documentation, and radiological supervision and interpretation required for the insertion.

2. Official Description

The official description of CPT code 36573 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; age 5 years or older.’

3. Procedure

1. The provider prepares the patient, who is five years of age or older, by ensuring 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.
9. The provider confirms the position of the catheter tip using imaging guidance or a chest X-ray and secures the entry site of the catheter with sutures.
10. The insertion site is cleaned, and sterile gauze and an adhesive dressing are applied.