Coding central venous access procedures

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Intravenous literature: Simply put, venous catheterization is a way to access veins. A central venous access catheter or device is used to deliver medications, intravenous fluids or obtain blood samples. Central venous access catheters and central venous access devices (VADs) are two different methods of venous catheterization. The appropriate procedural coding of central venous catheters and central venous devices (CVD) is somewhat problematic for many coders. This is in part due to the terminology used by physicians when describing the catheters and devices inserted. Some physicians use the term “vascular access device” to mean any type of central venous catheterization without providing adequate information as to the precise type inserted, whether it is a non-tunneled or tunneled central venous catheter or the insertion of a tunneled, implantable, either partially or totally, central VAD as defined in Coding Clinic and CPT Assistant. Also, the physician may not always document if the insertion site is central or peripheral. This lack of precise documentation for the procedures causes confusion and frustration on the part of the coder. This article will clarify the procedures and their associated codes for the insertion of intravenous central venous access catheters or devices, from both CPT and ICD-9-CM perspectives.

Vol. 14 Issue 1 Page 12

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