As noted with the central venous catheters (CVCs), PICC insertions are based on patient age (under 5 years of age, or 5 years and older), if there is a subcutaneous port/pump, and whether or not imaging guidance is used. For example, a PICC inserted without a port/pump and without imaging guidance in a child that is 3 years old is coded to 36568. If that same procedure is done on someone who is 5 years of age or older, then the CPT code 36569. If imaging guidance is used in the PICC procedure, the codes change to 36572 for younger than 5 years of age, or 36573 for 5 years of age or older.
The use of imaging guidance for the PICC insertions is all inclusive. This means that in addition to the radiological supervision and interpretation, any venography done through the same access site, the actual image documentation, as well as notation of the final catheter position are all included in the code. It would be inappropriate for a provider to assign an additional CPT code for the imaging to capture the final catheter position (if performed on the same date of service as the PICC insertion) since that is included in the codes with imaging guidance.
Insertion of PICCs with subcutaneous ports are distinguished by age (36570 for those under 5 years of age, and 36571 for those age 5 or older).
CPT codes to repair peripherally inserted central catheters are the same as for centrally inserted catheters (36575 for without a port/pump, or 36576 for with a port/pump). If only the catheter of a PICC with a port/pump needs replaced, the CPT code assigned is 36578 just like for CVC catheter only replacement. CPT code 36584 would be assigned for any PICC that had to be completely replaced and did not have a port/pump. For those PICCs with a port that need complete replacement, CPT code 36585 should be used. The total removal of a PICC with a port/pump is assigned to 36590.
The CPT Manual has a table for central venous access procedures that can be very helpful in determining the correct code to assign. With the different access points (central vs. peripheral), tunneled vs. non-tunneled, with or without port/pump, and ages to track, having the table consolidates the various information at a glance.
Now, light has been shed on coding PICCs.
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About the Author
Dianna Foley, RHIA, CHPS, CCS, CDIP, is an HIM professional with over 25 years of experience. She earned her bachelor’s degree from the University of Cincinnati and holds RHIA, CHPS, CDIP, and CCS certifications from AHIMA, along with being an AHIMA-approved ICD-10-CM/PCS trainer. Dianna has held many positions in HIM and is now an independent coding consultant. She previously served as the program director for Medical Coding and HIT at Eastern Gateway Community College. Dianna is an AHIMA-published author and has volunteered with AHIMA on projects including certification item writing, certification exam development, coding rapid design, and most recently has served on AHIMA’s nominating committee. She is a presenter on coding topics at the national, state, and regional levels and serves as OHIMA’s Education Coordinator. Dianna mentors new AHIMA members and also provides monthly educational lectures to coders and clinical documentation specialists.
