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Resolved 36561 vs 36571

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Question: What is the difference between codes:

36561 Insertion of tunneled centrally inserted central venous access device with subcutaneos
port; age 5 years or older.

36571 Insertion of peripherally inserted central venous access device, with subcutaneous port;
age 5 years or older.

Answer:
36561 - Insertion of tunneled centrally inserted central venous access device, with subcutaneous port age 5 years or older
36571 - Insertion of peripherally inserted central venous access device, with subcutaneous port age 5 years or older

In the CPT manual preceding code 36555 it says, "To qualify as a central venous access catheter or device, the tip of the catheter/device must terminate in the subclavian, brachiocephalic (innominate) or iliac veins, the superior or inferior vena cava, or the right atrium". Both of these codes are for a central venous access device. The difference is where the catheter entry site is. To paraphrase the CPT manual, the venous access device may be either centrally inserted, that is, inserted into the jugular, subclavian, femoral vein or inferior vena cava, OR it can be peripherally inserted, for example, inserted into the basilic or cephalic vein. So the difference of these codes is where the catheter is inserted. Further, if it is tunneled, it means that the entry site is different from the exit site.

Here are some related images:

CVC.jpg

And here is a good article on codepedia http://codapedia.com/article_578_Central-Lines-1-36555-36571-Why-How-When-and-Then-Some.cfm
 
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