Oncology & Hematology Coding Alert

Question: If port declotting is done during the same visit as chemotherapy administration, is it bundled into the infusion charges or can we code 36550?

Ohio Subscriber

Answer: Normally, medications given in addition to the chemotherapeutic agent are reported separately using the appropriate drug administration code. The service is usually performed by a registered nurse and is done under a physicians supervision.

However, 36550 (declotting by thrombolytic agent of implanted vascular access device or catheter) should only be used to report declotting of a partially or completely occluded implanted device or catheter. When using a thrombolytic agent such as urokinase, J3364-J3365, the medication is introduced through a syringe and then slowly placed into the device or catheter.

Code 36550 is not intended for performing routine flushing of vascular access devices with saline or heparin. This type of flushing is considered inclusive to chemotherapy services and is not reported separately. For partially or completely blocked devices or catheters, code 36550 in addition to the chemotherapy administration. And dont forget to bill for the drug used whether a routine port flush or declotting of a device or catheter is done.