PICC 2019: Move Point by Point Through Requirements for New and Revised Codes

CPT 2019 PICC updates

What’s the word to know for CPT® 2019 PICC updates? Imaging! Make sure your documentation and coding are ready to handle these three revisions and two additions for peripherally inserted central venous catheters, effective Jan. 1, 2019.

A tip for coding history buffs: The AMA CPT® Editorial Panel discussed these changes as far back as September 2017. The summary of panel actions is available online, but the information is a simple note that two new codes, a 36584 revision, and guideline clarifications were accepted.

Update Existing Code Requirements for PICC

Existing PICC insertion codes 36568 and 36569, as well as replacement code 36584, will all have revised descriptors in CPT® 2019. Here are the requirements, broken into bullet points:

36568

  • PICC insertion
  • No subcutaneous port or pump
  • Patient is younger than five
  • New for 2019: Without imaging guidance

36569

  • PICC insertion
  • No subcutaneous port or pump
  • Patient is five or older
  • New for 2019: Without imaging guidance

36584

  • Complete PICC replacement
  • No subcutaneous port or pump
  • Via same venous access
  • New for 2019: Includes imaging required to perform replacement:
    • Imaging guidance
    • Image documentation
    • Radiological supervision and interpretation.

Let’s sum up: For the existing insertion codes 36568 and 36569, the CPT® 2019 code descriptors clarify that the codes are appropriate when the provider performs the insertion without imaging guidance. On the other hand, the revision for replacement code 36584 specifies that the code includes imaging services required for the replacement.

Use New Codes When Documentation Shows Imaging

The AMA is adding two new PICC codes to the CPT® 2019 code set. The structure is similar to the codes above.

36572

  • PICC insertion
  • No subcutaneous port or pump
  • Patient is younger than five
  • New for 2019: Includes imaging required to perform insertion:
    • Imaging guidance
    • Image documentation
    • Radiological supervision and interpretation

36573

  • PICC insertion
  • No subcutaneous port or pump
  • Patient is five or older
  • New for 2019: Includes imaging required to perform insertion:
    • Imaging guidance
    • Image documentation
    • Radiological supervision and interpretation.

Reminder: Changes to codes and descriptors often result in changes to CPT® guidelines, too. Read through the guidelines for this code section in 2019 to give yourself both a refresher and an update on proper coding for PICC procedures.

What About You?

Do you code PICC insertion and replacement? Do you think the code changes make the codes a better match for current medical practice? What other changes would you like to see?

About 

Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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