Wiki Non tunneled central venomous catheter

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mfournier

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Hello Everyone:

Not sure if this is where I would post this question but I figure I would try.

I have a provider that code 36556, however not sure this is appropriate and what other code would be more appropriate.

This is the brief note

Time out performed: No (Emergent situation)
Patient place on monitor/pulse ox: No
MD prep: Mask, gown, gloves
Central Line prep: Chlorhexidine scrub, sterile draped applied
U/S used for placement: Yes
Central Line lumen inserted: Triple (16 Fr)
Post Procedure: Suture in place, good blood return, all ports aspirated, flushed, capped, sterile dressing applied, Biopatch place
Post Procedure x-ray: other pending
Patient tolerated procedure: well

General surgery consulted for assistance with CENTRAL LINE PLACEMENT on a 65 year old woman.

Area of IJ prepped and draped and sterile fashion. No topical anesthetic was given 2/2 to emergent situation and patient unconscious. The L IJ was entered with needle and guidewire, dilated and TLC was threaded through however resistance was felt with the passage of TLC and wire no longer visible on US. Therefore, procedure was terminated. A second kit was opened and a new needle, guidewire and dilator entered the L IJ and 16Fr catheter was then passed without difficulty. All ports were found to have good blood returned and flushed with ease. The TLD was sutured in place with biopatch applied.

Not sure this is truly 36556.

Thank you for any input.

MF
 
mfournier said:
Hello Everyone:

Not sure if this is where I would post this question but I figure I would try.

I have a provider that code 36556, however not sure this is appropriate and what other code would be more appropriate.

This is the brief note

Time out performed: No (Emergent situation)
Patient place on monitor/pulse ox: No
MD prep: Mask, gown, gloves
Central Line prep: Chlorhexidine scrub, sterile draped applied
U/S used for placement: Yes
Central Line lumen inserted: Triple (16 Fr)
Post Procedure: Suture in place, good blood return, all ports aspirated, flushed, capped, sterile dressing applied, Biopatch place
Post Procedure x-ray: other pending
Patient tolerated procedure: well

General surgery consulted for assistance with CENTRAL LINE PLACEMENT on a 65 year old woman.

Area of IJ prepped and draped and sterile fashion. No topical anesthetic was given 2/2 to emergent situation and patient unconscious. The L IJ was entered with needle and guidewire, dilated and TLC was threaded through however resistance was felt with the passage of TLC and wire no longer visible on US. Therefore, procedure was terminated. A second kit was opened and a new needle, guidewire and dilator entered the L IJ and 16Fr catheter was then passed without difficulty. All ports were found to have good blood returned and flushed with ease. The TLD was sutured in place with biopatch applied.

Not sure this is truly 36556.

Thank you for any input.

MF
Click to expand...
Placement of a CVC, also known as a central line, that is non-tunneled in someone over 5 yrs would be 36556.
 
Hello:

That's what I thought as well. But doesn't the note need to mention that the tip of the catheter must terminate in the subclavian, branchiocephalic, or iliac vein?
 
mfournier said:
Hello:

That's what I thought as well. But doesn't the note need to mention that the tip of the catheter must terminate in the subclavian, branchiocephalic, or iliac vein?
Click to expand...
Yes, I would send a query. Ours usually terminate in the vena cava so don't forget to add SVC, IVC and right atrium to your query.
 
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