CPT® Code 36598

Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image documentation and report

The procedure described by CPT® Code 36598 involves the use of contrast injection for the radiologic evaluation of an existing central venous access device (CVAD). This evaluation is crucial for ensuring the proper functioning and positioning of the central venous catheter (CVC). The fluoroscopic evaluation aims to confirm that the tip of the CVC is correctly positioned within the vascular system and to assess the integrity of the catheter, checking for any fractures or kinks that may impede its function. The procedure varies slightly depending on whether the CVC is equipped with a subcutaneous port or not. For CVCs without a port, a needle is inserted directly through the catheter hub to access the device. In contrast, for CVCs that include a port or pump, a specialized Huber needle is utilized for access. Once access is achieved, a contrast agent is injected into the catheter, allowing for the acquisition of fluoroscopic images. These images are critical for evaluating the patency of the catheter and identifying any potential leaks along its course. Following the contrast evaluation, the catheter is typically flushed with saline to clear any residual contrast, and an anticoagulant solution is administered to maintain catheter patency and prevent clot formation.