Anesthesia Coding Alert

Question: What is a PICC line, and how should I code it? The physician used it to drain a pelvic abscess.

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Answer: PICC is a common acronym for "peripherally inserted central catheter." However, the surgeon would not use a PICC line to drain an abscess; he would use a pelvic drainage catheter instead. Before coding anything, verify the procedure and what was used. Report abscess drainage with surgical code 49021 (Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess; percutaneous) or anesthesia code 00800 (Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified).
 
If the surgeon did insert a PICC line, the code range is 36488-36491, depending on the insertion method and the patient's age. Report 36488* (Placement of central venous catheter [subclavian, jugular, or other vein] [e.g., for central venous pressure, hyperalimentation, hemodialysis, or chemotherapy]; percutaneous, age 2 years or under) or 36489* (... percutaneous, over age 2) for percutaneous  insertion. Report 36490* (... cutdown, age 2 years or under) or 36491* (... cutdown, over age 2) if the physician makes an incision to directly visualize the blood vessel when inserting the catheter.