# portacath placement



## obxforbecbec@yahoo.com (Feb 24, 2015)

my surgeon saw a patient in the hospital dx colon ca and pulmonary embolism. he inserted a portacath to start chemo.  then removed the cath due to complications and replaced with another portacath.  he listed all individually and my biller billed each procedure. my question is what would be the correct way to bill this claim? Anthem BCBS does not like (did not pay) for the removal and replacement.


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## jjhamer1 (Feb 25, 2015)

First of all...after placing the first port-a-cath ... did the surgeon remove the cath during the first encounter? Or was there a complication ... and the surgeon then went back to remove the port-a-cath and then replaced the cath on that encounter?

36590 - Removal of tunneled central venous access device, w/subcutaneous port or pump, central or peripheral insertion

36561 - Insertion of tunneled centrally inserted central venous access device, w/subcutaneous port; age 5 years of older

36582 - Replacement, complete, of a tunneled centrally inserted central venous access device, w/subcutaneous port, through same venous access

Note: If surgeon removed and replaced VAD through same venous access, 36582 would be appropriate.


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