General Surgery Coding Alert

Question: When our surgeon replaces a PICC line, we report 36584, but I don’t see a code for removing the PICC line. Should we use the same code?

Connecticut Subscriber

Answer: No, you should not list the replacement code for Peripherally Inserted Central venous Catheter (PICC) for removing the line.

CPT^® provides the following two PICC line replacement codes, one of which you mentioned:

• 36584 — Replacement, complete, of a peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, through same venous access
• 36585 — Replacement, complete, of a periph­erally inserted central venous access device, with subcutaneous port, through same venous access.

CPT^® also provides two codes for removing tunneled central venous catheters, which you should also not use to report removal of a PICC line:

• 36589 — Removal of tunneled central venous catheter, without subcutaneous port or pump
• 36590 — Removal of tunneled central venous access device, with subcutaneous port or pump, central or peripheral insertion.

In fact, a text note following those codes states, “Do not report 36589 or 36590 for removal of non-tunneled central venous catheters.”

Do this: You shouldn’t separately report a procedure code for PICC line removal. CPT^® does not provide a code for non-tunneled catheter removal, such as taking out a PICC line. These access lines are intended to be more short term, and removal is included as part of the follow up to a procedure or as part of an E/M service performed on that date.