Summary & Overview
CPT 36580: Replacement of Non-Tunneled Central Venous Catheter
CPT code 36580 denotes the complete replacement of a non‑tunneled central venous access (CVA) catheter due to blockage, damage, or malfunction. The code captures a targeted, often urgent vascular intervention that affects inpatient and outpatient procedural workflows and resource use nationwide. This code matters nationally because central venous access is common across oncology, critical care, and procedural specialties; accurate coding affects quality reporting, facility planning, and claims adjudication. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical description, typical sites of service, payer coverage context, and guidance on the types of benchmarks and policy updates to look for when evaluating utilization and reimbursement for catheter replacement procedures. The publication outlines clinical context for why replacements occur, common billing modifiers associated with procedural variability, and where to expect differences across commercial and government payers. Data not provided in the input (such as specific payer rates, ICD‑10 mappings, and related codes) are noted as unavailable; the focus remains on the code definition, operational considerations, and what national stakeholders should monitor regarding utilization trends and reimbursement policy changes.
Billing Code Overview
CPT code 36580 describes a complete replacement of a non–tunneled central venous access (CVA) catheter performed when the existing catheter is blocked, damaged, or otherwise malfunctioning. This procedure involves removing the existing non-tunneled catheter and inserting a new non-tunneled central venous catheter during the same encounter.
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Service type: Invasive vascular procedure for catheter replacement
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Typical site of service: Hospital inpatient, hospital outpatient department, or ambulatory surgical center depending on clinical urgency and patient status
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 62-year-old hospitalized patient with end-stage renal disease on intermittent hemodialysis presents with inability to use a non-tunneled central venous access (CVA) catheter due to occlusion and catheter malfunction after several weeks of use. The patient is febrile and the catheter lumen will not aspirate blood despite attempts at thrombolytic therapy. Interventional radiology or a vascular surgery team evaluates the patient and determines that the non-tunneled CVA catheter must be completely removed and replaced with a new non-tunneled central venous catheter under sterile technique. The procedure is typically performed in an inpatient or outpatient interventional suite, emergency department, or operating room depending on clinical status. Workflow includes pre-procedure assessment (including consent and review of indications such as catheter blockage, damage, or malfunction), ultrasound-guided venous access or exchange, removal of the existing non-tunneled catheter, placement of a new non-tunneled central venous catheter, confirmation of catheter tip position (fluoroscopy or chest radiograph), and post-procedure monitoring for complications such as pneumothorax, bleeding, or infection. Documentation should include indication, details of the complete replacement, method of guidance, catheter type and size, site, laterality, estimated blood loss, anesthetic agents, and any complications or additional services provided.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier reported (default) |