© Copyright 2025 American Medical Association. All rights reserved.
A peripherally inserted central venous catheter (PICC) is a specialized type of intravenous line designed for the prolonged delivery of medications or fluids directly into the bloodstream. Unlike standard intravenous lines, which typically terminate in peripheral veins, a PICC's tip is positioned in larger central veins, such as the innominate, subclavian, or iliac veins, and can extend to the vena cava or the right atrium. The insertion of a PICC line involves accessing a suitable large vein, often located in the arm, such as the basilic, cephalic, or brachial vein, or in some cases, the saphenous vein in the leg. The procedure for inserting a PICC line without imaging guidance is generally performed at the bedside and is considered a blind insertion technique. Initially, the planned insertion site is thoroughly cleansed, and a local anesthetic is administered to minimize discomfort. The catheter is then carefully inserted into the chosen venous access site and advanced through the central venous system until the distal tip reaches the lower third of the superior vena cava, specifically near the cavoatrial junction. To ensure the correct placement of the catheter tip before initiating intravenous therapy, a chest X-ray is typically performed to confirm its location. In adults with healthy heart function, an alternative method of insertion without imaging guidance may involve bedside magnetic navigation and electrocardiography (ECG). This technique utilizes a specially designed magnetic-tipped catheter that provides real-time feedback on the catheter's position, thereby reducing the risk of malposition and eliminating the need for additional X-ray exposure. After successful insertion, the PICC is secured with sutures, and a dressing is applied to the insertion site on the arm. The CPT® Code 36568 is specifically designated for the insertion of a non-tunneled PICC line without imaging guidance in patients younger than 5 years of age.
© Copyright 2025 Coding Ahead. All rights reserved.
The insertion of a peripherally inserted central venous catheter (PICC) is indicated for various clinical situations, particularly when prolonged intravenous access is required. The following conditions may warrant the use of a PICC:
The procedure for inserting a PICC line without imaging guidance involves several critical steps to ensure proper placement and patient safety. The following outlines the procedural steps:
After the insertion of a PICC line, several post-procedure care steps are essential to ensure patient safety and the proper functioning of the catheter. Patients are typically monitored for any immediate complications, such as bleeding or signs of infection at the insertion site. It is important to educate patients and caregivers on how to care for the PICC line, including keeping the insertion site clean and dry, recognizing signs of infection, and understanding the importance of maintaining the catheter's patency. Regular follow-up appointments may be necessary to assess the catheter's function and to perform any required maintenance, such as flushing the line to prevent clot formation. Additionally, patients should be informed about the need for periodic imaging to confirm the catheter's position, especially if they experience any unusual symptoms.
| Short Descr | INSJ PICC <5 YR W/O IMAGING | Medium Descr | INSERTION PICC W/O IMG GDN < 5 YR | Long Descr | Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, without imaging guidance; younger than 5 years of age | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No 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) | 1 - Statutory 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). | 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 |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2019-01-01 | Changed | Description Changed |
| 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. |
Get instant expert-level medical coding assistance.