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A tunneled centrally inserted central venous catheter (CVC) is a medical device that is inserted into a large vein to provide long-term access to the bloodstream. This procedure is specifically indicated for patients younger than 5 years of age. The catheter is designed to terminate in major veins such as the subclavian, brachiocephalic, or iliac veins, as well as the superior or inferior vena cava, or the right atrium. The insertion of a tunneled CVC involves creating a subcutaneous tunnel that allows the catheter to be placed into the jugular, subclavian, or femoral vein, with the jugular vein being the most commonly used access site for this type of device. The procedure typically requires the use of local anesthesia at the puncture site to minimize discomfort. The Seldinger technique is employed to access the chosen vein, which involves puncturing the skin and vein with a needle, followed by the insertion of a guidewire. This guidewire facilitates the creation of a subcutaneous tunnel through which the catheter is advanced. The placement of the catheter is confirmed through imaging guidance, which may be separately reportable, ensuring that the catheter tip is positioned correctly within the central venous system. After the catheter is secured and the incision is closed, a dressing is applied to protect the insertion site. This procedure is crucial for patients requiring long-term intravenous therapy, such as chemotherapy or total parenteral nutrition.
© Copyright 2025 Coding Ahead. All rights reserved.
The insertion of a tunneled centrally inserted central venous catheter (CVC) is indicated for the following conditions:
The procedure for the insertion of a tunneled centrally inserted central venous catheter involves several critical steps:
After the insertion of the tunneled centrally inserted central venous catheter, the patient is monitored for any immediate complications, such as bleeding or infection at the insertion site. Instructions for care of the catheter and the insertion site are provided to the patient or caregiver, including signs of infection to watch for and how to maintain the catheter. Follow-up appointments may be scheduled to assess the catheter's function and to perform any necessary maintenance, such as flushing the catheter to prevent clot formation. The expected recovery time may vary, but patients are generally advised to avoid strenuous activities that could stress the insertion site during the initial healing period.
| Short Descr | INSERT TUNNELED CV CATH | Medium Descr | INSERT TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR | Long Descr | Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; younger than 5 years of age | Status Code | Active Code | Global Days | 010 - Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 2 | CCS Clinical Classification | 54 - Other vascular catheterization, not heart |
This is a primary code that can be used with these additional add-on codes.
| 37252 | Addon Code MPFS Status: Active Code APC N ASC N1 Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel (List separately in addition to code for primary procedure) | 37253 | Addon Code MPFS Status: Active Code APC N ASC N1 Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (List separately in addition to code for primary procedure) |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AG | Primary physician | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | RT | Right side (used to identify procedures performed on the right side of the body) | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2007-01-01 | Changed | Code description changed. |
| 2004-01-01 | Added | First appearance in code book in 2004. |
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