Summary & Overview
CPT 36558: Central Venous Catheter Placement for Medication/Nutrition
CPT code 36558 covers the insertion of a central venous catheter (without a subcutaneous port or pump) into a major vein draining to the heart or directly into the right atrium for intravenous administration of medications, nutrition, or fluids in patients aged five years and older. This procedure is a key component of acute and chronic inpatient and outpatient care when reliable central venous access is required for therapies such as long-term intravenous antibiotics, parenteral nutrition, or vasoactive infusions. Nationally, the code matters because central venous access procedures are common, resource- and skill-intensive, and subject to payer-specific coverage policies and site-of-service distinctions that affect billing and care pathways.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and which payers are commonly involved. The publication summarizes benchmarking considerations, coding and billing nuances relevant to payer coverage, and policy updates that influence reimbursement and utilization management. Where input data is not provided, the publication notes that specific fields are unavailable and focuses on national-level implications for clinicians, billing professionals, and policy stakeholders.
Billing Code Overview
CPT code 36558 describes the placement of a tunneled or nontunneled central venous catheter, without a subcutaneous port or infusion pump, into a major vein that carries blood to the heart or directly into the right atrium for administration of medications, nutrients, or fluids. The procedure is specified for an individual five years of age or older.
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Service type: Intravascular device insertion (central venous catheter placement)
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Typical site of service: Hospital inpatient or outpatient procedure areas and ambulatory surgical centers; may also be performed in interventional radiology suites or specialized procedure rooms depending on clinical needs and facility capabilities.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 62-year-old hospitalized adult requiring long-term intravenous access for chemotherapy, total parenteral nutrition, or prolonged antibiotic therapy. The patient presents to an interventional radiology or inpatient procedural suite after informed consent; pre-procedure evaluation includes review of labs (coagulation panel, platelet count), imaging to assess central venous anatomy if needed, and verification of indications. Under sterile technique and local anesthesia with conscious sedation as appropriate, the provider accesses a major central vein (eg, internal jugular, subclavian, or femoral), advances the catheter into a central venous position terminating near the cavoatrial junction or right atrium, and secures and dresses the catheter. Post-procedure chest radiograph or fluoroscopic confirmation is performed to verify tip position and to exclude pneumothorax when applicable. Nursing provides catheter care education, documentation of catheter length and lumens, and coordination for home infusion services or inpatient medication administration. Discharge planning includes follow-up for catheter maintenance, dressing changes, and instructions for signs of infection or malfunction.
Coding Specifications
- Use the most clinically relevant modifiers below when billing
36558.
| Modifier | Description | When to Use |
|---|---|---|
26 |