CPT® Code 36560

A tunneled centrally inserted central venous catheter (CVC) with a subcutaneous port is a specialized medical device used for long-term intravenous access in pediatric patients, specifically those younger than 5 years of age. This procedure involves the careful placement of a catheter that 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 catheter is tunneled subcutaneously, which means it is inserted through a tunnel created under the skin, allowing for a more discreet and less visible access point. The most common site for accessing the venous system for this type of device is the jugular vein, although the subclavian and femoral veins may also be utilized. The insertion of a tunneled CVC is typically performed under local anesthesia, ensuring that the patient experiences minimal discomfort during the procedure. The Seldinger technique is commonly employed, which involves puncturing the skin and vein with a needle, followed by the insertion of a guidewire to facilitate the placement of the catheter. This method is favored for its safety and effectiveness in achieving central venous access. The procedure may also involve the use of imaging guidance to accurately position the catheter tip in the desired central location, which is crucial for the proper functioning of the device. Overall, this procedure is essential for patients requiring long-term intravenous therapy, such as those undergoing chemotherapy, total parenteral nutrition, or frequent blood draws.