CPT® Code 36590

A tunneled central venous access device (CVC) is a specialized catheter that is inserted into a large vein, typically for long-term access to the bloodstream. The procedure described by CPT® Code 36590 involves the removal of such a device that includes a subcutaneous port or pump. This type of CVC is often used for patients requiring frequent blood draws, medication administration, or other intravenous therapies. The removal process begins with the administration of a local anesthetic to minimize discomfort. The skin over the venous access site is then incised, allowing for access to the device. Unlike the removal of a tunneled CVC without a subcutaneous port or pump, which is covered under CPT® Code 36589, this procedure requires additional steps to carefully dissect the port or pump from the surrounding tissue. After the device is freed from the tunnel, it is removed along with the catheter. To ensure patient safety, any bleeding at the site is controlled through manual pressure, and the incision is subsequently closed and dressed to promote healing. This procedure is critical for patients who no longer need the device or who may be experiencing complications related to its presence.