# 36558 or 36569



## BABS37 (Jan 3, 2013)

I can't tell which code to use for a central venous line. Here's the OP Note. I keep leaning towards 36568 bc it says 'punctured' so non tunneled? Yikes!!!!! Thoughts?

'After adequate sedation was achieved, the left chest was prepped and draped. The subclavian vein was accessed. Percutaneous puncture and guide wire was passed distally under fluoroscopy. The wire was positioned in the SVC. Dilator was inserted then triple lumen central catherter was inserted over the wire. The wire was removed. The catheter was flushed and aspirated nicely. The tip was positioned in the SVC and the catheter was secured with Nurulon.'


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## MCook (Jan 4, 2013)

36569 has an entry site in the basilic or cephalic vein in the arm and is threaded into the superior vena cava above the right atrium.
36558 has an entry site in the inferior vena cava or the jugular, subclavian, or femoral vein.

Based on the above and the documentation you provided; I would select 36558.


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## BABS37 (Jan 4, 2013)

Thank you for your help! That's a great explanation! Sorry about the typo!


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## MCook (Jan 5, 2013)

You're welcome  Glad I could help.


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## dpeoples (Jan 7, 2013)

BABS37 said:


> I can't tell which code to use for a central venous line. Here's the OP Note. I keep leaning towards 36568 bc it says 'punctured' so non tunneled? Yikes!!!!! Thoughts?
> 
> 'After adequate sedation was achieved, the left chest was prepped and draped. The subclavian vein was accessed. Percutaneous puncture and guide wire was passed distally under fluoroscopy. The wire was positioned in the SVC. Dilator was inserted then triple lumen central catherter was inserted over the wire. The wire was removed. The catheter was flushed and aspirated nicely. The tip was positioned in the SVC and the catheter was secured with Nurulon.'



Assuming this is an adult patient, I would look at 36556.

HTH


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## MCook (Jan 8, 2013)

Danny,
Can you expand on why you would select the 36556 over 36558?  I think it is because of it being non-tunneled.  I zeroed in on the two codes presented and didn't consider others.  I'm curious to your thought process as I'm always trying to understand all the catheter codes better.  
I appreciate your time!


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