Implantable Access Systems - Smiths Medical

Reimbursement Information > Implantable Access Systems 

Procedure CPU APE C Code Description 

Code 1 Code Code 2 

Venous Access Portal Systems 

Implantation 36560 0623 C1788 Insertion of tunneled centrally inserted central venous access device, with 

subcutaneous port; under 5 years of age. 

36561 0623 C1788 Age 5 years or older. 

36570 0622 C1788 Insertion of peripherally inserted central venous access device, with 

subcutaneous port; under 5 years of age. 


Repair 36576 0621 N/A Repair of central venous access device, with subcutaneous port or pump, 

central or peripheral insertion site. 

Partial Replacement of 36578 0622 C1751 Replacement, catheter only, of central venous access device, with 

Central Venous Access 

Device (Catheter Only) 

subcutaneous port or pump, central or peripheral insertion site. 

Complete Replacement 36582 0623 C1788 Replacement, complete, of a tunneled centrally inserted central venous 

of Central Venous Access 

Device Through Same 

Venous Access Site 

access device, with subcutaneous port, through same venous access. 

36585 0622 C1788 Replacement, complete, of a peripherally inserted central venous access 

device, with subcutaneous port, through same venous access. 

Removal 36590 0621 N/A Removal of tunneled central venous access device, with subcutaneous port or 

pump, central or peripheral insertion. 

Code 36590 cannot be reported for removal for non-tunneled central 

venous catheters. 

Mechanical Removal of 36595 0622 N/A Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) 

Obstructive Material from central venous device via separate venous access. 

Code 36550 cannot be reported in addition to 36596. 

To report venous catheterization, consult CPU codes 36010-36012. 

To report radiological supervision and interpretation, consult CPU code 75901. 

36596 0621 N/A Mechanical removal of intraluminal (intracatheter) obstructive material from 

central venous device through device lumen 




Declotting 36550 0676 N/A Declotting by thrombolytic agent of implanted vascular access device or catheter. 

Epidural Systems 

Catheter Implantation, 62350 0223 C1751 Implantation, revision or repositioning of tunneled intrathecal or epidural 

Revision, Repositioning catheter, for long-term medication administration via an external pump or 

If an intrathecal or 

epidural is placed 

percutaneously, consult 

CPU codes 62270-62273, 

62280-62284 and 

62310-62319 

implantable reservoir/infusion pump; without laminectomy. 

62351 0208 C1751 With laminectomy 

Catheter Removal 62355 0203 N/A Removal of previously implanted intrathecal or epidural catheter 

Epidural Injection 62318 0207 N/A Injection, including catheter placement, continuous infusion or intermittent 

bolus, not including neurolytic substances, with or without contrast (for either 

localization or epidurography), of diagnostic or therapeutic substance(s) 

(including anesthetic antispasmodic, opioid, steroid, other solution), epidural or 

subarachnoid; cervical or thoracic. 

Portal Placement 62360 0226 C1788 Implantation or replacement of device for intrathecal or epidural drug 

infusion; subcutaneous reservoir. 

Portal Removal 62365 0221 N/A Removal of subcutaneous reservoir or pump previously implanted for 

intrathecal or epidural infusion.



Peritoneal Systems 

Portal Implantation 49419 0115 C1788 Insertion of intraperitoneal cannula or catheter, with subcutaneous reservoir, 

permanent (i.e. totally implantable). 

Catheter Removal 49422 0105 N/A Removal of permanent intraperitoneal cannula or catheter. 

Arterial Systems 

Catheter Implantation 36640 0623 C1751 Arterial catheterization for prolonged infusion therapy (chemotherapy), cutdown. 

Portal Placement 37799 0103 N/A Unlisted procedure, vascular surgery 

Venous Catheter (CVC’s) 

Placement 36555 0621 C1751 Insertion of non-tunneled centrally inserted central venous catheter; under 

5 years of age 


36557 0622 C1751 Insertion of tunneled centrally inserted central venous catheter, without 

subcutaneous port or pump; under 5 years of age. 


Repair 36575 0621 N/A Repair of tunneled or non-tunneled central venous access catheter, without 


Complete Replacement 36580 0621 C1751 Replacement, complete, of a non-tunneled centrally inserted central venous 




(catheter) 

catheter, without subcutaneous port or pump, through same venous access. 

Complete Replacement 36581 0622 C1751 Replacement, complete, of a tunneled centrally inserted central venous 




(catheter) 


Repositioning 36597 0621 N/A Repositioning of previously placed central venous catheter under 

fluoroscopic guidance. 

To report fluoroscopic guidance, consult CPU code 76000. 

Removal of Central 36589 0621 N/A Removal of tunneled central venous catheter, without subcutaneous port 

Venous Access Device or pump. 

Venous Catheter (PICC’s) 

Placement 36568 0621 C1751 Insertion of peripherally inserted central venous catheter (PICC), without 





Complete Replacement of 36584 0621 C1751 Replacement, complete, of a peripherally inserted central venous catheter 




(catheter) 

(PICC), without subcutaneous port or pump, through same venous access. 



To report fluoroscopic guidance, consult CPU code 76000). 

Removal of Central 36589 0621 N/A Removal of tunneled central venous catheter, without subcutaneous port 

Venous Access Device or pump. 

Venous Catheter 

(CVC’s and PICC’s) 

Mechanical Removal of 36595 0622 N/A Mechanical removal of pericatheter obstructive material (eg. fibrin sheath) 





Mechanical Removal of 36596 0621 N/A Mechanical removal of intraluminal (intracatheter) obstructive material from 

Obstructive Material central venous device through device lumen. 




Declotting 36550 0676 N/A Declotting by thrombolytic agent of implanted vascular access device or catheter. 



Venous Access 

Hemodialysis 

Insertion 36565 0623 C1752 Insertion of tunneled centrally inserted central venous access device, 

requiring two catheters via two separate venous access sites: without 

subcutaneous port or pump (eg, Tesio type catheter) 

Placement 36555 0621 C1752 Insertion of non-tunneled centrally inserted central venous catheter; under 

5 years of age 


36557 0622 C1752 Insertion of tunneled centrally inserted central venous catheter, without 





Complete Replacement of 36580 0621 N/A Replacement, complete, of a non-tunneled centrally inserted central venous 




(catheter) 


Complete Replacement of 36581 0622 N/A Replacement, complete, of a tunneled centrally inserted central venous 




(catheter) 




To report fluoroscopic guidance, consult CPU code 76000. 

Removal of Central Venous 36589 0621 N/A Removal of tunneled central venous catheter, without subcutaneous port or 

Access Device pump. 

Mechanical Removal of 36595 0622 N/A Mechanical removal of pericatheter obstructive material (eg. fibrin sheath) 





36596 0621 N/A Mechanical removal of intraluminal (intracatheter) obstructive material from 

central venous device through device lumen. 




Additional Procedures 2 

Consultation 99201- 

99252 

0600 N/A Consultation/evaluation and management of new or established patient. 

3 

Vascular Injection 36005 N/A N/A Injection procedure for extremity venography (including introduction of 

Procedure needle or intracatheter). 

To report radiological supervision and interpretation, consult CPU codes 

75820 and 75822. 

Venography 75820 0668 N/A Venography, extremity, unilateral, radiological supervision and interpretation. 

75860 0668 N/A Venography, sinus or jugular, radiological supervision and interpretation. 

75872 0279 N/A Venography, epidural, radiological supervision and interpretation. 

Fluoroscopy 76000 0272 N/A Fluoroscopy (separate procedure), up to one hour physician time. 

Ultrasound Guidance 76937 N/A N/A Ultrasound guidance for vascular access requiring ultrasound evaluation of 

potential access sites, documentation of selected vessel patency, concurrent 

real time ultrasound visualization of vascular needle entry, with 

permanent recording and reporting (list separately in addition to code for 

primary procedure) 

Included in allowance for procedure 

Do not use 76937 in conjunction with 76942. 

If extremity venous non-invasive vascular diagnostic study is performed 

separate from venous access guidance, use 93965, 93970 or 93971.

Device and Supply Codes Factored into the APE Code Reimbursement 

Devices supplies and equipment are included in the Medicare allowance for the reported major procedure. 

Device or Supply HCPC APE C Code Description 

Code Code Code2 Implantable Venous 

Catheters 

A4300 N/A N/A Catheters (CVC’s, midlines, PICC’s and hemodialysis) 

Implantable Access A4301 N/A N/A Implantable access total system; catheter, port/reservoir (e.g., venous, arterial, 

System epidural, subarachnoid, peritoneal etc.), percutaneous access. 

Medical and Surgical A4212 N/A N/A Non-coring needle or stylet with or without catheter (GRIPPER ® Supplies 

needles). 

A4550 N/A N/A Surgical trays. 

A4649 N/A N/A Surgical supply, miscellaneous. 

Heparin J1642 N/A N/A Injection, heparin sodium, (heparin Lock Flush), per 10 units 

Port flushing reminder: 

If a special visit is made to a hospital outpatient department for Port flushing, CPU code 99211 (brief office visit) should be used. Codes 96520 (refilling and 

maintenance of portable pump) and 96530 (refilling and maintenance of implantable pump or reservoir), while a payable service, should NOT be used to 

report flushing of a Port. Port flushing should not be billed if it is done on the same day as pump refilling and maintenance, as it is included in the service. 

1 

2 

CPU is a registered trademark of the American Medical Association. CPU® is copyright 2006 AMA. All rights reserved. 

Although the C Codes expired, they may continue to be used for data collection purposes. 

The information provided by Smiths Medical MD with this notice is general reimbursement information only; it is not legal advice, nor is it advice about 

how to code, complete or submit any particular claim for payment, nor intended to increase or maximize reimbursement by any third party payer. This 

information was correct at the time of publication (February, 2006); however, it is always the responsibility of the provider to determine appropriate coding 

and charges for insurance claims. All coding and reimbursement information is subject to change without notice. Payers or their local branches may 

have their own coding and reimbursement requirements and policies. Before filing any claims, providers should verify current requirements and policies 

with the payer. 

If you have any questions regarding reimbursement for Smiths Medical MD, Inc. 

access systems, please contact our Reimbursement Services staff at 1-800-433-5832. 

Smiths Medical MD, Inc. has provided this reimbursement information to the best of its knowledge; however, it makes no guarantee concerning 

costs of goods and services or amounts of reimbursement. It is always the provider’s responsibility to determine appropriate codes and charges 

for insurance claims. 

GRIPPER and the Smiths design mark are trademarks of the smith Medical family of companies. 

The symbol ® indicates the trademark is registered in the U.S. Patent Office and certain other countries. 

Hackman is a Bard Access System trademark. 

©2006 Smiths Medical family of companies. All rights reserved. 2/06 19437 

Customer and Clinical Services 1-800-426-2448 

www.smith-medical.com

Implantable Access Systems - Smiths Medical

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