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Official Description

Replacement, complete, of a non-tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 36580 involves the complete replacement of a non-tunneled centrally inserted central venous catheter (CVC) without the presence of a subcutaneous port or pump. This procedure is performed through the same venous access site, which means that the existing access point is utilized for the replacement rather than creating a new one. The need for replacement typically arises when the catheter experiences issues such as partial or complete obstruction, or other malfunctions that compromise its functionality. During the procedure, radiographs may be obtained to ensure that the tip of the newly placed CVC is correctly positioned within the vascular system. The replacement process includes the placement of a guidewire through the existing catheter, allowing for the withdrawal of the old catheter over the guidewire. Subsequently, a new catheter is advanced over the guidewire, with its tip being positioned in one of several key anatomical locations, including the subclavian vein, brachiocephalic vein, iliac vein, superior vena cava, inferior vena cava, or the right atrium. Once the new catheter is in place, it is secured with sutures to prevent displacement and is either flushed with heparin to maintain patency or connected to intravenous tubing for the administration of fluids or medications. This procedure is critical for patients requiring long-term venous access for treatment, ensuring that they receive necessary therapies without interruption due to catheter-related issues.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 36580 is indicated for patients who require the replacement of a non-tunneled centrally inserted central venous catheter (CVC) due to various complications. These indications include:

  • Catheter Obstruction: When the existing catheter becomes partially or completely obstructed, preventing the proper flow of fluids or medications.
  • Catheter Malfunction: Any malfunction of the catheter that compromises its ability to function effectively for intravenous therapy.
  • Infection: Presence of infection at the catheter site or within the catheter itself may necessitate replacement to prevent further complications.
  • Catheter Damage: Physical damage to the catheter that may affect its integrity and functionality.

2. Procedure

The procedure for the complete replacement of a non-tunneled centrally inserted central venous catheter (CVC) involves several critical steps:

  • Step 1: Preparation and Anesthesia The patient is positioned comfortably, and the area around the existing catheter is cleaned and sterilized. Local anesthesia may be administered to minimize discomfort during the procedure.
  • Step 2: Guidewire Placement A guidewire is carefully inserted through the existing catheter. This guidewire serves as a pathway for the new catheter and is essential for the replacement process.
  • Step 3: Catheter Withdrawal The old catheter is withdrawn over the guidewire. This step is crucial as it ensures that the new catheter can be placed without the need for a new venous access site.
  • Step 4: New Catheter Insertion A new non-tunneled CVC is then advanced over the guidewire. The tip of the new catheter is positioned in one of the major veins, such as the subclavian vein, brachiocephalic vein, iliac vein, superior vena cava, inferior vena cava, or the right atrium, ensuring optimal placement for intravenous therapy.
  • Step 5: Securing the Catheter Once the new catheter is in the correct position, it is secured with sutures to prevent movement or dislodgment. This step is vital for maintaining the catheter's position during use.
  • Step 6: Flushing and Connection The new catheter is flushed with heparin to maintain patency or connected to intravenous tubing for the administration of fluids or medications, ensuring that the catheter is ready for immediate use.

3. Post-Procedure

After the procedure, the patient is monitored for any immediate complications, such as bleeding or signs of infection at the catheter site. The catheter's placement is confirmed through imaging, if necessary, to ensure proper positioning. Patients may be advised on care instructions for the catheter site, including how to keep it clean and signs of potential complications to watch for. Follow-up appointments may be scheduled to assess the catheter's function and the patient's overall condition.

Short Descr REPLACE CVAD CATH
Medium Descr RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP
Long Descr Replacement, complete, of a non-tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access
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 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)
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
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).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
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.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
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.)
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
FS Split (or shared) evaluation and management visit
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
LT Left side (used to identify procedures performed on the left side of the body)
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
Q3 Live kidney donor surgery and related services
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)
SG Ambulatory surgical center (asc) facility service
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
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
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2004-01-01 Added First appearance in code book in 2004.
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