CPT® Code 36563

The CPT® Code 36563 refers to the procedure of inserting a tunneled centrally inserted central venous access device (CVC) that includes a subcutaneous pump. This procedure is essential for patients requiring long-term venous access for the administration of medications, fluids, or for other therapeutic purposes. A central venous 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, ensuring efficient delivery of treatment. The tunneled CVC is specifically placed through a subcutaneous tunnel, which allows for a more secure and less visible access point, typically utilizing the jugular, subclavian, or femoral veins. The jugular vein is the most common site for this type of device. During the procedure, imaging guidance may be employed to accurately access the venous entry site and to position the catheter tip correctly within the central venous system. Local anesthesia is administered to minimize discomfort at the puncture site. The Seldinger technique is utilized to access the jugular vein, which involves puncturing the skin and vein with a needle, followed by the insertion of a guidewire. A subcutaneous pocket is created for the pump, and a tunnel is formed from the venous access site to this pocket. The catheter is then advanced through the tunnel and positioned in the appropriate central vein. The placement of the catheter is confirmed through radiographic imaging. Finally, the catheter is connected to the pump, which is secured in the subcutaneous pocket, and the incision is closed, ensuring the device is properly sutured in place for optimal function and patient comfort.