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The CPT® Code 36583 refers to the complete replacement of a tunneled centrally inserted central venous access device, specifically a subcutaneous pump, through the same venous access site. This procedure is necessary when both the central venous catheter (CVC) and the subcutaneous pump are malfunctioning. The process begins with the examination of the existing device to determine the need for replacement. The procedure involves accessing the subcutaneous pocket where the pump is located, inspecting the catheter for any occlusions or damage, and utilizing a guidewire to facilitate the removal of the old catheter. A new catheter is then inserted, ensuring that its tip is correctly positioned in one of the major veins, such as the subclavian, brachiocephalic, iliac vein, superior or inferior vena cava, or right atrium. Following the placement of the new catheter, a new subcutaneous pump is installed, and the connection between the catheter and the pump is tested for leaks. Finally, the subcutaneous pocket is closed, completing the replacement process. This code is specifically used when a pump is involved, distinguishing it from similar procedures that may involve a port instead.
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The procedure associated with CPT® Code 36583 is indicated for patients who require the replacement of a malfunctioning tunneled centrally inserted central venous access device with a subcutaneous pump. The specific indications for this procedure include:
The procedure for CPT® Code 36583 involves several critical steps to ensure the successful replacement of the tunneled central venous access device:
After the completion of the procedure, patients are typically monitored for any immediate complications related to the replacement of the central venous access device. Post-procedure care may include instructions on how to care for the insertion site, signs of infection to watch for, and guidelines for the use of the new pump. Patients may also be advised on follow-up appointments to ensure proper function of the new device and to address any concerns that may arise during the recovery period.
| Short Descr | REPLACE TUNNELED CV CATH | Medium Descr | RPLCMT COMPL TUN CTR VAD W/SUBQ PMP | Long Descr | Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous pump, through same venous access | 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 | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | 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.) | 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) |
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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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