Anesthesia Coding Alert

Question: How should we charge for a double lumen Hickman catheter? I want to use 36533, but am unsure if this is correct.

California Subscriber

Answer: The answer to your situation depends on the mechanism for implantation rather than the name of the catheter. Code 36533 (insertion of implantable venous access device, with or without subcutaneous reservoir) should be used for partially implanted devices that include a visible external site remote from the venous entry site and do not have subcutaneous reservoirs. These catheters are distinguished from central venous catheters by the technique used to create the tunnel the catheter lies in.

More appropriate codes for the placement of a central venous catheter would be 36488* (placement of central venous catheter [subclavian, jugular or other vein] [e.g., for central venous pressure, hyperalimenta6tion, hemodialysis or chemotherapy]; percutaneous, age 2 years or under); 36489* (placement of central venous catheter; percutaneous, over age 2); 36490* (placement of central venous catheter; cutdown, age 2 years or under); and 36491* (placement of central venous catheter, cutdown, over age 2). All partially implanted central venous access devices are currently reported using 36533, as you suggested.


Answers to Reader Questions and You Be the Coder provided by Barbara Newberry, coding manager with the CRNA practice group Watchcare Anesthesia Inc., in Berryville, Ark.