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Central line placement

Riyaz Posted Wed 03rd of April, 2013 19:48:51 PM

My physician noted that he inserted central line through right femoral vein and that triple lumen catheter was advanced over the wires into the right femoral vein. To code 36556 ( patient is over 5 years old ) it has to terminate in subclavian,brachiocephalic,illiac vein; the superior or inferior vena cava; or the right atrium. What is the cpt-4 code if it didn't terminate in any of above areas?

SuperCoder Answered Thu 04th of April, 2013 08:17:33 AM

Physician need not mention at which point the tip of CVP catheter ended. Indication for coding a CVP (in this case 36556) is the mention of placing the catheter through central insertion point (subclavian, femoral, iliac etc.) or through periphery (cephalic, basilic vein etc.). Usually a guidewire and subsequently the catheter is inserted through Femoral vein and then guided via Iliac vein till inferior vena cava. There is no specific code for "central line" if the tip did not terminate at the specific venous locations. In fact, it then becomes just a normal venous catheter insertion, not a CVP placement.

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