CPT® Code 36558

A tunneled centrally inserted central venous catheter (CVC) is a medical device that is surgically placed into a large vein to provide long-term access to the bloodstream. This procedure is specifically indicated for patients aged 5 years or older. The catheter is designed to terminate in major veins such as the subclavian, brachiocephalic, or iliac veins, as well as the superior or inferior vena cava, or the right atrium. The placement of a tunneled CVC involves creating a subcutaneous tunnel that allows the catheter to be inserted into the jugular, subclavian, or femoral vein, with the jugular vein being the most commonly used access site for this type of device. The procedure typically requires the administration of local anesthesia at the puncture site to minimize discomfort. The Seldinger technique is employed to access the chosen vein, which involves puncturing the skin and vein with a needle, followed by the insertion of a guidewire. This guidewire facilitates the creation of a subcutaneous tunnel and the subsequent placement of the catheter. The catheter is advanced through this tunnel to ensure it reaches the appropriate central position within the venous system. The placement is confirmed through imaging techniques, which may be reported separately. After successful placement, the catheter is secured, and the incision site is closed and dressed appropriately. This procedure is essential for patients requiring long-term intravenous therapy, such as chemotherapy or total parenteral nutrition.