CPT® Code 36568

Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, without imaging guidance; younger than 5 years of age

A peripherally inserted central venous catheter (PICC) is a specialized type of intravenous line designed for the prolonged delivery of medications or fluids directly into the bloodstream. Unlike standard intravenous lines, which typically terminate in peripheral veins, a PICC's tip is positioned in larger central veins, such as the innominate, subclavian, or iliac veins, and can extend to the vena cava or the right atrium. The insertion of a PICC line involves accessing a suitable large vein, often located in the arm, such as the basilic, cephalic, or brachial vein, or in some cases, the saphenous vein in the leg. The procedure for inserting a PICC line without imaging guidance is generally performed at the bedside and is considered a blind insertion technique. Initially, the planned insertion site is thoroughly cleansed, and a local anesthetic is administered to minimize discomfort. The catheter is then carefully inserted into the chosen venous access site and advanced through the central venous system until the distal tip reaches the lower third of the superior vena cava, specifically near the cavoatrial junction. To ensure the correct placement of the catheter tip before initiating intravenous therapy, a chest X-ray is typically performed to confirm its location. In adults with healthy heart function, an alternative method of insertion without imaging guidance may involve bedside magnetic navigation and electrocardiography (ECG). This technique utilizes a specially designed magnetic-tipped catheter that provides real-time feedback on the catheter's position, thereby reducing the risk of malposition and eliminating the need for additional X-ray exposure. After successful insertion, the PICC is secured with sutures, and a dressing is applied to the insertion site on the arm. The CPT® Code 36568 is specifically designated for the insertion of a non-tunneled PICC line without imaging guidance in patients younger than 5 years of age.