# Help coding PICC double lumen



## cherylbr (Dec 19, 2018)

Our anesthesiologist performed the following procedure:




Narrative 
Procedure: PICC Placement



Type: Midline
Number of lumen: Double Lumen
PICC Tube/Line Size: 7 FR
Brand and lot: Arrow  Exp. Date: _______
Line length: 20
Laterality : Right
Location: Brachial
Prep: Chlorhexidine
Local anesthetic: Injectable 

Placement verification: Blood return and Ultrasound
Number of sutures: 0
Note: Referred by Dr.___  for need for intravenous medication as 
outpatient.
Patient brought to Day hospital, pre-procedure evaluation completed, 
reviewed patient's allergies, medical and surgical history, medications, 
and lab results.  Patient on ________ currently for duration of catheter in 
place.
Discussed the risks, benefits, and alternatives to midline placement.  
Patient agrees with plan and consents to procedure.

Procedure note:

Patient in supine position.  Timeout completed.  Sterile prepped and 
draped.  Scouted with ultrasound on right arm.  Brachial vein adequate for 
catheter placement, localized skin using 5mL 2% lidocaine.  

18G angiocath placed with ultrasound guidance, wire advanced easily 
through 18G catheter.  Site dilated and 20cm double lumen midline catheter 
placed over wire.  Ports flushed easily with saline, however white port 
had no blood return. 

Catheter secured with Benzoin and PICC line catheter tegaderm.  Site 
cleaned and dried.  
Patient tolerated procedure well, vital signs stable post procedure.

Would 36571 be appropriate?  Seems to be denying for a modifier.  Unclear why as no other procedure was provided by our anesthesiologist that day.  Help please!


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## Davieda Skobel (Feb 19, 2019)

Couple of questions regarding the procedure.
They may just want Left or Right added to the procedure code.
The documentation though states a " midline" was inserted so your code may be incorrect.
Midlines are coded with 36400 thru 36410.
I found good information on them in my AMA CPT Professional code book. I always check the coding tips at the front of each section.
If the Dr inserted a PICC line and you have the correct code then you may need to just add left or right.
I would check with the Dr before I resubmitted it first. It's all about the where the catheter enters and where the tip terminates.

This is just my opinion I hope it helps you.
Good luck.
Davieda Skobel CLPN, CPC
Columbus, Ohio


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