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A tunneled centrally inserted central venous catheter (CVC) with a subcutaneous port is a specialized medical device used for long-term intravenous access in pediatric patients, specifically those younger than 5 years of age. This procedure involves the careful placement of a catheter that 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 catheter is tunneled subcutaneously, which means it is inserted through a tunnel created under the skin, allowing for a more discreet and less visible access point. The most common site for accessing the venous system for this type of device is the jugular vein, although the subclavian and femoral veins may also be utilized. The insertion of a tunneled CVC is typically performed under local anesthesia, ensuring that the patient experiences minimal discomfort during the procedure. The Seldinger technique is commonly employed, which involves puncturing the skin and vein with a needle, followed by the insertion of a guidewire to facilitate the placement of the catheter. This method is favored for its safety and effectiveness in achieving central venous access. The procedure may also involve the use of imaging guidance to accurately position the catheter tip in the desired central location, which is crucial for the proper functioning of the device. Overall, this procedure is essential for patients requiring long-term intravenous therapy, such as those undergoing chemotherapy, total parenteral nutrition, or frequent blood draws.
© Copyright 2025 Coding Ahead. All rights reserved.
Insertion of a tunneled centrally inserted central venous access device with a subcutaneous port is indicated for the following conditions:
The procedure for the insertion of a tunneled centrally inserted central venous access device with a subcutaneous port involves several critical steps:
After the insertion of the tunneled centrally inserted central venous access device with a subcutaneous port, the patient will require monitoring for any immediate complications, such as bleeding or infection at the insertion site. Patients are typically advised on care for the access site, including keeping it clean and dry, and recognizing signs of infection. Follow-up appointments may be necessary to assess the function of the device and to perform routine maintenance, such as flushing the catheter to prevent clot formation. The expected recovery time can vary, but patients are generally able to resume normal activities with some restrictions based on their overall health and the reason for the catheter placement.
| Short Descr | INSERT TUNNELED CV CATH | Medium Descr | INSJ TUNNELED CTR VAD W/SUBQ PORT UNDER 5 YR | Long Descr | Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; 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 | Non office-based surgical procedure added in CY 2008 or later; 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) |
| 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. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 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.) | 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) | 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 |
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| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2007-01-01 | Changed | Code description changed. |
| 2004-01-01 | Added | First appearance in code book in 2004. |
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