AHA Coding Clinic® for HCPCS - 2014 Issue 1; Ask the Editor

CPT code 36593

Patient has an infusion port, port-a-cath or a central venous access device that flushes sluggishly due to obstruction (clot). Instead of saline or heparin being used to irrigate or flush the access device, a thrombolytic agent (tPA) is utilized for irrigation or flushing. How would the instillation of the thrombolytic agent be reported if it were the only service provided, and if it were administered via an intravenous push (IVP), or followed by a lab draw? Which CPT code would be more appropriate to report, 96523, Irrigation of implanted venous access device for drug delivery systems; 36593, Declotting by thrombolytic agent of implanted vascular access device or catheter; or 96374, Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug? ...

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