Summary & Overview
CPT 36406: Pediatric Peripheral Venous Access, Under 3 Years
CPT code 36406 identifies a pediatric venous access procedure involving needle insertion into a peripheral vein (excluding scalp, jugular, and carotid veins) for patients under three years of age. The code captures a focused clinical intervention commonly performed in emergency, inpatient, and outpatient pediatric settings and matters nationally because safe, timely vascular access in very young patients affects care delivery, procedural success rates, and resource use across health systems. Key payers in typical coverage analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. This publication provides a concise reference for clinical and billing staff about the code’s clinical context, typical sites of service, and where it fits within pediatric vascular access services. Readers will find benchmarks and coverage considerations where available, a description of common payment modifiers and coding relationships, and guidance on documentation elements relevant to reporting the service. Data not available in the input will be noted explicitly in applicable sections. The summary is intended for national audiences including clinicians, coding professionals, and policy analysts seeking a clear understanding of CPT code 36406 and its role in pediatric vascular access care.
Billing Code Overview
CPT code 36406 describes a procedure in which a provider inserts a needle into a vein other than the scalp, jugular, or carotid vein for a patient who is less than three years old. This procedure is an age-specific venous access technique performed on infants and toddlers.
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Service type: Pediatric peripheral venous access
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Typical site of service: Inpatient unit, emergency department, or outpatient clinical setting where pediatric intravenous access is required
Clinical & Coding Specifications
Clinical Context
A typical patient is an infant or toddler under three years of age presenting to the pediatric emergency department or inpatient unit requiring reliable intravenous access for fluid resuscitation, medication administration, blood sampling, or contrast delivery. The clinician (pediatrician, emergency physician, or pediatric hospitalist) performs peripheral venous access using a needle placed into a peripheral vein other than the scalp, jugular, or carotid — commonly the dorsum of the hand, forearm, or foot. The workflow includes assessment of the patient and indication, obtaining parental consent, preparation with appropriate pediatric supplies and size-appropriate needle, application of topical anesthetic or comfort measures, aseptic skin preparation, venipuncture and catheter/needle securement, verification of intravascular placement (aspiration of blood and/or flushing), documentation of site, size and laterality, and post-procedure monitoring for infiltration, extravasation, or infection. This procedure is used when peripheral access is needed and central access is not indicated or feasible, and when scalp or central neck vessels are contraindicated or reserved for other techniques.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | (Not a standard CMS modifier for billing) | Data not available in the input. |
11 |