Cardiology Coding Alert

Question: I’m new to cardiology, and I don’t understand PICC coding, especially codes 36572, 36573, and 36584. Can you explain these codes to me?

Maine Subscriber

Answer: Through guidelines and parenthetical notes, CPT® identifies specific rules to follow when reporting 36572 (Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the insertion; younger than 5 years of age); 36573 (… age 5 years or older); and 36584 (Replacement, complete, of a peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, through same venous access, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the replacement).

Follow these tips to keep your PICC claims in tip-top shape:

• Never report 71045 (Radiologic examination, chest; single view) through 71048 (… 4 or more views) to document the final catheter position on the same day of service as 36572, 36573, or 36584.
• Since 36572, 36573, and 36584 include confirmation of the catheter tip location, the cardiologist who reports image-guided PICC insertion cannot report the confirmation of the catheter tip location separately.
• If the cardiologist performs a 36572, 36573, or 36584 service but does not confirm the catheter tip’s location, then you should append modifier 52 (Reduced services) to the appropriate code.
• Never report 36572 or 36573 in conjunction with +76937 (Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concur­rentrealtime ultrasound visualization of vascular needle entry, with permanent recording and reporting (List separately in addition to code for primary procedure)) or +77001 (Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic supervision and interpretation, and radiographic documentation of final catheter position) (List separately in addition to code for primary procedure)).
• Never report 36584 in conjunction with +76937 or +77001.