CPT® Code 36595

Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access

The CPT® Code 36595 refers to the mechanical removal of obstructive material, such as a fibrin sheath, from a central venous device through a separate venous access. This procedure is typically indicated when a semi-permanent central venous catheter (CVC) experiences complications due to the formation of a fibrin sheath at its tip, which can lead to obstruction or diminished flow. The process begins with the confirmation of the obstruction via a venogram, which is a diagnostic imaging study that visualizes the veins. Once the obstruction is confirmed, a new venous access site is established to facilitate the removal of the obstructive material. The procedure involves several technical steps, including the placement of a sheath, the introduction of a guidewire, and the use of a snare-guiding catheter to reach the obstruction. The obstructive material is then mechanically stripped away using the snare, allowing for the restoration of patency to the CVC. This procedure is crucial for maintaining the functionality of the central venous device and ensuring proper patient care.