© 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 administration of medications or fluids directly into the bloodstream. Unlike standard intravenous lines, which typically terminate in peripheral veins, a PICC's tip is strategically positioned in larger central veins such as the innominate, subclavian, or iliac veins, or even in the superior vena cava or right atrium. This positioning allows for more effective delivery of treatments, especially in pediatric patients under the age of five, who may require long-term intravenous therapy. The insertion of a PICC involves accessing a suitable large vein in the arm, often one of the deeper veins located above the elbow, such as the basilic, cephalic, or brachial veins, or the saphenous vein in the leg. The procedure is performed under sterile conditions, beginning with the cleansing of the planned insertion site using a bactericidal solution, followed by the application of a tourniquet to engorge the vein and facilitate access. A local anesthetic is administered to minimize discomfort during the procedure. There are two primary techniques for inserting a PICC: the peel-away cannula technique and the Seldinger technique, both of which ensure that the catheter is accurately placed into the central venous system. This procedure includes all necessary imaging guidance, documentation, and radiological supervision to confirm the correct placement of the catheter tip, ensuring optimal patient care and safety.
© Copyright 2025 Coding Ahead. All rights reserved.
The insertion of a peripherally inserted central venous catheter (PICC) is indicated for various clinical scenarios, particularly in pediatric patients under the age of five. The following conditions may warrant the use of a PICC:
The procedure for inserting a PICC involves several critical steps to ensure proper placement and patient safety. The following outlines the procedural steps:
After the insertion of the PICC, appropriate post-procedure care is essential to ensure the catheter remains functional and to prevent complications. The insertion site should be monitored for signs of infection, such as redness, swelling, or discharge. Regular assessments of the catheter's patency and position are necessary, and the dressing should be changed according to facility protocols. Patients may require education on how to care for the PICC line, including instructions on maintaining hygiene and recognizing potential complications. Follow-up imaging may be necessary to confirm the correct placement of the catheter tip within the central venous system.
| Short Descr | INSJ PICC RS&I <5 YR | Medium Descr | INSERTION PICC W/RS&I < 5 YR | Long Descr | Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the insertion; 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 | Procedure or Service, Multiple Reduction Applies | 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) | none | MUE | 1 |
| 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.) | 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) | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | 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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| 2019-01-01 | Added | Added |
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