Two new codes to report dilation of a urinary tract percutaneous access for endourologic procedures were created.
CPT Code 36568 or 36569 for the insertion of a PICC line depending on the patient’s age and Codes 36584 or 36585 for the replacement of a PICC line. #•10005 Fine needle aspiration biopsy, including ultrasound guidance; first lesion, +#•10006 each additional lesion (List separately in addition to code for primary procedure), #•10007 Fine needle aspiration biopsy, including fluoroscopic guidance; first lesion, +#•10008 each additional lesion (List separately in addition to code for primary procedure), #•10009 Fine needle aspiration biopsy, including CT guidance; first lesion, +#•10010 each additional lesion (List separately in addition to code for primary procedure), #•10011 Fine needle aspiration biopsy, including MR guidance; first lesion, +#•10012 each additional lesion (List separately in addition to code for primary procedure). Reporting the placement of a midline catheter is also addressed in new introductory language. When imaging guidance is performed for all other centrally inserted central venous catheters, for gaining access to the venous entry site and/or for manipulating the catheter into final central position, imaging guidance codes 76937 or 77001 may be reported separately, when documentation of such guidance is supported. Two new codes have been introduced to represent peripherally inserted central venous catheters (PICCs). Do not report 76937 or 77001 in conjunction with 36568, 36569, and do not report 76937 or 77001 with 36572, 36573, 36584.
Question: When coding the placement of an infusion device such as a peripherally inserted central catheter (PICC line), the code assignment for the body part is based on the site in which the device ended up (end placement). CPT 36572 and 36573 are brand new codes published this year to report placement of a PICC line with imaging guidance. The publication is provided “as is” without warranty of any kind, either expressed or implied, including, but not limited to, implied warranties or merchantability and fitness for a particular purpose. The CPT guidelines were also updated to indicate that a PICC line replacement through the same venous access without any imaging guidance, is now reported with unlisted CPT code 37799. Fax (703) 691-1855, 3975 Fair Ridge Drive A 36 year-old patient presents for insertion of a single lumen midline catheter for intravenous access for infusion. Copyright © 2020 Society of Interventional Radiology.
Additionally, a revision has been made to CPT code 36584 for PICC replacement to describe PICC replacement performed with imaging guidance. Codes 36572, 36573 and 36582 include confirmation of the catheter tip location. SIR is providing this billing and coding guide for educational and information purposes only. Based on CPT-4, code 76937 (ultrasonic guidance) may be separately assigned with code 36410 when ultrasonic guidance is utilized.
CPT codes “50436 Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (e.g., ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, with postprocedure tube placement, when performed” and “50437 including new access into the renal collecting system” include dilation urinary tract, all imaging guidance to the dilation procedure and postprocedure tube placement, when performed.
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