AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2017 Issue 2; Ask the Editor

Tunneled Catheter versus Totally Implantable Catheter

The patient underwent conversion of a non-tunneled dialysis catheter to a tunneled dialysis catheter. The existing catheter was removed. The new catheter was placed in the right internal jugular vein and advanced over a guidewire into position. A subcutaneous tunnel was then formed along the upper chest by blunt dissection. The catheter was brought through the tunnel. Limbs of the catheter were connected, tested for flushing and aspiration, and then sutured. Fluoroscopy confirmed placement of the catheter in the right atrium. How should the tunneled catheter placement be coded? There appears to be some confusion as to how to code tunneled venous catheter placement. The tunneled catheter is not totally implanted and a subcutaneous pocket is not created. What procedure codes should be assigned? Are two codes assigned, one for the central venous catheter, which was threaded into the right atrium, as well as the tunneled portion of the catheter, which resides in the subcutaneous chest tissue? ...

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