CPT® Code 36591

The CPT® Code 36591 refers to the procedure of collecting a blood specimen from a completely implantable venous access device (IVAD). An IVAD is a medical device that allows for easy access to the venous system for the administration of medications, fluids, or for blood draws. The procedure begins with the identification of the IVAD's septum, which is located by palpating the skin over the device. This is a critical step to ensure accurate needle placement. Once located, the skin is cleansed to reduce the risk of infection. A specialized needle known as a Huber needle, which is designed with a side hole to facilitate blood collection, is then inserted into the IVAD at a precise 90-degree angle. This angle is important to ensure that the needle properly accesses the internal reservoir of the IVAD. After the initial blood aspiration, the device is flushed with normal saline to maintain patency and prevent clot formation. The procedure involves careful handling of the extension tubing and the use of a Vacutainer system to collect the blood specimen efficiently. The process may involve multiple blood specimen tubes, and proper flushing with saline and heparin is performed to ensure the IVAD remains functional for future use. This detailed approach is essential for maintaining the integrity of the IVAD and ensuring accurate blood specimen collection.