Radiology Coding Alert

Question: Our patient's permanent catheter had a cracked clamp and hub on the arterial port. Our radiologist repaired it, then aspirated and flushed it to confirm that he had fixed it properly. After the radiologist repacked the catheter with heparinized saline, the patient was able to use it again. Which code should we report for this
repair service?

North Dakota Subscriber

Answer: You're in luck - CPT 2004 recently introduced the new code 36575 (Repair of tunneled or non-tunneled central venous access catheter, without subcutaneous port or pump, central or peripheral insertion site) to describe this type of catheter repair.
 
Although 36575's descriptor doesn't specifically refer to a cracked clamp or hub, the AMA's CPT Changes 2004: An Insider's View offers the following procedural description, which is very similar to yours:
 
"A new catheter hub segment is spliced onto the existing catheter and the splice tested with injection. The catheter is then redressed and flushed in standard fashion."
 
You should, therefore, use 36575 for this service.

 - The answers for You Be the Coder and Reader Questions were reviewed by Cindy C. Parman, CPC, CPC-H, RCC, co-owner of Coding Strategies Inc. in Dallas, Ga.; Gary S. Dorfman, MD, FACR, FSIR, past representative to the AMA's CPT Advisory Committee from the Society of Interventional Radiology; and Deborah I. Churchill, RTT, president of Churchill Consulting Inc. in Killingworth, Conn.