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The CPT® Code 36596 refers to the mechanical removal of intraluminal obstructive material from a central venous device through its lumen. This procedure addresses a common complication associated with semi-permanent central venous catheters (CVCs), which is the buildup of obstructive material that can lead to complete occlusion or significantly reduced flow through the catheter. In simpler terms, when a CVC becomes blocked, it can hinder the delivery of medications or fluids, making it essential to restore its functionality. The procedure involves accessing the CVC, which may or may not have a subcutaneous port. For CVCs without a port, a guidewire is utilized for access, while those with a port or pump require a Huber needle for entry. Once access is achieved, a guidewire is advanced into the port or pump reservoir, followed by the introduction of a snare-guiding catheter or a balloon catheter through the existing catheter lumen. The guidewire is then removed, and the obstructive material is addressed either by using a snare to strip it away or by inflating the balloon catheter to alleviate the blockage. After the obstruction is cleared, the snare and catheter are withdrawn, and the patency of the CVC is confirmed by injecting intravenous fluid to ensure proper flow is restored.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 36596 is indicated for patients experiencing complications related to central venous catheters, specifically when there is an accumulation of intraluminal obstructive material. This obstruction can lead to:
The mechanical removal of obstructive material from a central venous device involves several critical steps to ensure the successful restoration of catheter function. The procedure begins with the appropriate access to the central venous catheter. For CVCs that do not have a subcutaneous port, a guidewire is utilized to gain access. In contrast, for CVCs equipped with a port or pump, a Huber needle is employed to access the device. Once access is established, a guidewire is carefully advanced into the port or pump reservoir, which is crucial for the subsequent steps.
Post-procedure care following the mechanical removal of obstructive material from a central venous device includes monitoring the patient for any immediate complications or signs of re-obstruction. It is essential to assess the effectiveness of the procedure by ensuring that the catheter is patent and functioning correctly. Healthcare providers should also provide instructions for care of the catheter site and educate the patient on signs of potential complications, such as swelling, redness, or pain at the insertion site, which may require further evaluation. Regular follow-up may be necessary to ensure continued catheter function and to address any future complications that may arise.
| Short Descr | MECH REMOV TUNNELED CV CATH | Medium Descr | MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN | Long Descr | Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen | Status Code | Active Code | Global Days | 000 - Endoscopic or 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) | 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 | 63 - Other non-OR therapeutic cardiovascular procedures |
| 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). | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 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. | 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). | 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.) | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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) | 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) | 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 | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2004-01-01 | Added | First appearance in code book in 2004. |
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