Non-tunneled Catheter & Subcutaneous Port Procedures ASDIN Coding University 1

Non-Tunneled Catheters There are unique codes, separate from those that are used for tunneled catheters that are designated for use with non-tunneled devices These codes are not reserved for use with dialysis catheters They can, in fact, be used for any type of catheter that is to be used for any purpose 2

Catheter Insertion is the code for non-tunneled catheter insertion The descriptor for this code is - insertion of non- tunneled centrally inserted central venous catheter, over 5 years of age 3

Repair & Exchange is the code for non-tunneled catheter repair The descriptor for this code is - repair of tunneled or non-tunneled central venous access catheter, without subcutaneous port or pump is the code for non-tunneled catheter exchange The descriptor for this code is - replacement, complete, of a non-tunneled centrally inserted central venous catheter, without subcutaneous port or pump through the same venous access 4

Non-Tunneled Catheter Removal The removal of a non-tunneled catheter is not a codable event 5

Additional Codes The codes for ultrasound and fluoroscopic guidance may be appropriately used with a non-tunneled catheter procedures ultrasound guided cannulation for catheter insertion This code requires that an image be recorded and made part of the permanent record fluoroscopic guidance used in connection with the placement of a central venous device This code includes any angiographic study that might be performed in conjunction with the catheter placement 6

Subcutaneous Port Procedures There are unique codes, separate from those that are used for tunneled catheters that are designated for use with subcutaneous ports 7

Port Insertion For the insertion of a port the code is The descriptor for this code is - insertion of tunneled centrally inserted central venous access device, with subcutaneous port, over 5 years of age For the insertion of two ports the code is The descriptor for this code is - Insertion of tunneled centrally inserted central venous access device, requiring two catheters via two separate venous access sites, with subcutaneous port(s) It should be noted that this code requires that the two ports be placed from separate access sites 8

Port Replacement For the replacement of a catheter associated with a port the code is The descriptor for this code is - replacement, catheter only, of central venous access device, with subcutaneous port or pump, through same venous access For the replacement of the complete port the code is The descriptor for this code is - replacement, complete, of a centrally inserted central venous access device, with subcutaneous port 9

Port Removal For the removal of a port the code is The descriptor for this code is - Removal of tunneled central venous catheter, with subcutaneous port or pump 10

Additional Codes The codes for ultrasound and fluoroscopic guidance may be appropriately used with subcutaneous port procedures ultrasound guided cannulation for catheter insertion This code requires that an image be recorded and made part of the permanent record fluoroscopic guidance used in connection with the placement of a central venous device This code includes any angiographic study that might be performed in conjunction with the device placement 11

Important Note This document is for informational purposes only and should serve as a guideline for appropriate coding. The ultimate responsibility for correct coding /documentation remains with the provider of service. ASDIN makes no representation, warranty, or guarantee that this compilation of information is error-free, nor that the use of this guide will prevent differences of opinion or disputes with CMS or any other carrier. ASDIN will bear no responsibility or liability for the results or consequences that may grow out of the use of this guidance. 12