Radiology Coding Alert

Clue in to when you're more likely to see tunneled vs. non-tunneled.

Savvy coders know they can't let a catheter name dictate their central venous access (CVA) device coding. Although physicians typically tunnel some brands of catheters and not others, you should never base your coding on assumptions.

Hickman, Broviac, and Groshong catheters typically are tunneled, while Hone and triple-lumen catheters are non-tunneled.

"Because tunneled catheters help prevent infection from colonization, they're a good choice for catheters placed for chronic conditions such as dialysis or chemotherapy," says Scott Groudine, MD, of Albany Medical Center in Albany, N.Y. "If the catheter is placed urgently and for short-term use, it probably will not need to be tunneled."

Although these terms can provide a clue to proper coding, you should not rely on them exclusively. Likewise, if the physician documents placement of a Tesio-type catheter, be sure the device has two separate access sites before reporting 36565 or 36566. Follow the questions outlined in "Interventional Radiology" on page 84 for a complete picture of the CVA's purpose so you can choose the correct code.