CPT® Code 36583

Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous pump, through same venous access

The CPT® Code 36583 refers to the complete replacement of a tunneled centrally inserted central venous access device, specifically a subcutaneous pump, through the same venous access site. This procedure is necessary when both the central venous catheter (CVC) and the subcutaneous pump are malfunctioning. The process begins with the examination of the existing device to determine the need for replacement. The procedure involves accessing the subcutaneous pocket where the pump is located, inspecting the catheter for any occlusions or damage, and utilizing a guidewire to facilitate the removal of the old catheter. A new catheter is then inserted, ensuring that its tip is correctly positioned in one of the major veins, such as the subclavian, brachiocephalic, iliac vein, superior or inferior vena cava, or right atrium. Following the placement of the new catheter, a new subcutaneous pump is installed, and the connection between the catheter and the pump is tested for leaks. Finally, the subcutaneous pocket is closed, completing the replacement process. This code is specifically used when a pump is involved, distinguishing it from similar procedures that may involve a port instead.