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The CPT® Code 36563 refers to the procedure of inserting a tunneled centrally inserted central venous access device (CVC) that includes a subcutaneous pump. This procedure is essential for patients requiring long-term venous access for the administration of medications, fluids, or for other therapeutic purposes. A central venous 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, ensuring efficient delivery of treatment. The tunneled CVC is specifically placed through a subcutaneous tunnel, which allows for a more secure and less visible access point, typically utilizing the jugular, subclavian, or femoral veins. The jugular vein is the most common site for this type of device. During the procedure, imaging guidance may be employed to accurately access the venous entry site and to position the catheter tip correctly within the central venous system. Local anesthesia is administered to minimize discomfort at the puncture site. The Seldinger technique is utilized to access the jugular vein, which involves puncturing the skin and vein with a needle, followed by the insertion of a guidewire. A subcutaneous pocket is created for the pump, and a tunnel is formed from the venous access site to this pocket. The catheter is then advanced through the tunnel and positioned in the appropriate central vein. The placement of the catheter is confirmed through radiographic imaging. Finally, the catheter is connected to the pump, which is secured in the subcutaneous pocket, and the incision is closed, ensuring the device is properly sutured in place for optimal function and patient comfort.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 36563 is indicated for patients who require long-term central venous access for various medical treatments. The following conditions may warrant the use of a tunneled centrally inserted central venous access device with a subcutaneous pump:
The procedure for inserting a tunneled centrally inserted central venous access device with a subcutaneous pump involves several critical steps to ensure proper placement and functionality:
After the insertion of the tunneled centrally inserted central venous access device with a subcutaneous pump, patients are typically monitored for any immediate complications, such as bleeding or infection at the insertion site. Instructions for care of the site, including keeping it clean and dry, are provided to the patient. Patients may also receive guidance on how to manage the pump and recognize signs of potential complications, such as catheter occlusion or infection. Follow-up appointments are essential to assess the function of the device and to ensure that it remains properly positioned and free from complications. Recovery time may vary depending on the individual patient's condition and the complexity of the procedure, but most patients can resume normal activities within a short period, barring any complications.
| Short Descr | INSERT TUNNELED CV CATH | Medium Descr | INSJ TUNNELED CTR VAD W/SUBQ PUMP | Long Descr | Insertion of tunneled centrally inserted central venous access device with subcutaneous pump | 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) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | 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) | P8F - Endoscopy - bronchoscopy | MUE | 1 | 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. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 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.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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) | 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. |
| 2004-01-01 | Added | First appearance in code book in 2004. |
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