Anesthesia Coding Alert

Question: Which surgical and anesthesia codes best describe Groshong catheter placements?

Oregon Subscriber
 
Answer: A Groshong catheter is a brand name for one type of central catheter. CPT 2004 completely revised the catheter codes, but the patient's age and the type of catheter (tunneled or nontunneled) are still the primary differences between them. Because Groshong catheters are always tunneled, you simply must determine the patient's age to select the appropriate code.
 
The most common codes for Groshong placements are 36560 (Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; under 5 years of age) or 36561 (... age 5 years or older), depending on the patient's age. The corresponding anesthesia code is 00532 (Anesthesia for access to central venous circulation).

If the physician places the catheter in the patient's forearm, consider 36820 (Arteriovenous anastomosis, open; by forearm vein transposition) instead. This crosses to anesthesia code 01844 (Anesthesia for vascular shunt, or shunt revision, any type [e.g., dialysis]).

Physicians often insert Groshong catheters in patients' necks for dialysis, so you'll probably report 36560/36561 or 00532 most of the time.