# Tunneled cath removal



## Licorice5 (Sep 13, 2011)

A cath was inserted in June (36558) and paid by Medicare. The end of August this cath was removed (36589) and denied as already included in payment for another service. These were the only 2 services provided. I cannot find where the removal is included in the insertion code and the global days are 10 so it's well after the global period.
Any suggestions?


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## rhondatalley (Sep 13, 2011)

Were any procedures performed by a different physician/different practice?  Where was this procedure performed?


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## Licorice5 (Sep 14, 2011)

No, all procedures were performed by same physician.


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## sdodson (Sep 15, 2011)

*tunneled catheter removal*

CPT 36558 is insertion of a tunneled central venous catheter (i.e. perm cath for dialysis). The removal of the device is included with the placement and no charges should be billed. Same for removing a feeding tube.


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## donnajrichmond (Sep 15, 2011)

In the case of a tunneled catheter, the removal is NOT included.  There is a separate code as the original poster noted.  Removal of a non-tunneled catheter is not separately billed, but removal of a tunneled cath requires more work and so was valued separately.


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