General Surgery Coding Alert

Question: What code should we bill when we remove a central venous pressure (CVP) line and insert a Hickman catheter at a different site? New York Subscriber Answer: You can't determine the proper code based on type of catheter (such as CVP line or Hickman). Selecting the proper code depends on the patient's age, whether the surgeon places the catheter centrally or peripherally, where the catheter tip is at the end of placement, and whether the catheter is tunneled or non-tunneled. Surgeons typically place Hickman catheters as central lines, and they usually place them centrally, although they can be tunneled or non-tunneled. For an adult patient, that makes the most likely codes for your scenario either 36556 (Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older) or 36558 (Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or older). [...]