Summary & Overview
CPT 36590: Removal of Tunneled Central Venous Device and Port
CPT code 36590 represents the surgical removal of a tunneled central venous access device together with its subcutaneous port or pump. This code captures definitive device explantation procedures commonly performed when a central or peripheral access device is no longer needed, is malfunctioning, or is associated with complications. Nationally, timely and accurate reporting of this service is important for care coordination, quality tracking of vascular access management, and correct claims processing.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise profile of the clinical context for device removal, typical sites of service where the procedure occurs, and the payer landscape affecting coverage and claim submission. The publication outlines benchmarks for utilization and allowed services, highlights recent policy updates affecting billing and documentation, and situates the procedure within care pathways for vascular access management. Practical billing considerations such as common modifiers and documentation expectations are summarized. Data not available in the input is noted for areas such as specific ICD-10 mappings and related CPT codes.
Billing Code Overview
CPT code 36590 describes the removal of a tunneled central venous access device along with the subcutaneous port or pump that was previously placed through a central or peripheral insertion. This procedure involves explanting both the tunneled catheter and its attached port or infusion pump.
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Service type: Device removal / surgical removal of vascular access device
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Typical site of service: Ambulatory surgical center, hospital outpatient department, or inpatient surgical setting depending on clinical context and patient status
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with a history of long-term chemotherapy for metastatic colorectal cancer presents for removal of a tunneled central venous access device and subcutaneous port after completion of therapy. The device is functioning but no longer required. The removal is scheduled electively in an outpatient or ambulatory surgical center setting under local anesthesia with or without monitored anesthesia care. The clinical workflow includes pre-procedure verification of consent and device, review of anticoagulation status, sterile preparation, incision and cuff/explant dissection, gentle withdrawal of the tunneled catheter and subcutaneous port or pump, inspection of the tract and catheter for intactness, hemostasis, wound closure, and post-procedure instructions. Documentation should include indication for removal, device type and laterality, anesthesia used, procedural steps (incision, dissection, removal technique), confirmation of intact device, estimated blood loss, complications (if any), and post-procedure plan including wound care and follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
52 | Reduced services | Use when the removal procedure is partially reduced or not completed as originally planned. |
53 |