Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the insertion; ag
CPT4 code
Name of the Procedure:
Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the insertion.
Summary
A peripherally inserted central catheter (PICC) is a long, thin tube inserted through a vein in the arm and threaded through to a larger vein near the heart. This procedure uses imaging technology to ensure accuracy and safety during placement.
Purpose
A PICC line is typically used for long-term intravenous (IV) therapy, such as antibiotics, chemotherapy, or nutrition. It helps deliver medications and nutrients directly into the bloodstream and reduces the need for frequent needle sticks.
Indications
- Need for extended IV therapy (more than a week)
- Administration of medications or fluids that could irritate smaller veins
- Difficulty accessing traditional veins
- Frequent blood draws
Preparation
- Fasting is usually not required.
- Inform your doctor of any medications, allergies, or underlying health conditions.
- Blood tests or imaging studies may be performed to check for contraindications.
Procedure Description
- The patient lies on an examination table, usually in an outpatient radiology department.
- The insertion site, typically in the upper arm, is cleaned and sterilized.
- Local anesthesia is administered to numb the insertion area.
- Using real-time imaging guidance (ultrasound and/or fluoroscopy), the PICC line is inserted into a vein and guided towards a larger vein near the heart.
- Confirmation of catheter placement is obtained through imaging.
- The catheter is secured with a sterile dressing.
Duration
The entire procedure typically takes about 30 to 90 minutes.
Setting
The procedure can be performed in a hospital, outpatient clinic, or surgical center equipped with radiology services.
Personnel
- Interventional radiologist or specially trained healthcare provider
- Radiology technician
- Nurse
Risks and Complications
- Bleeding
- Infection at the insertion site
- Thrombosis (blood clots)
- Catheter occlusion or malfunction
- Discomfort at the insertion site
- Rarely, injury to nearby arteries or nerves
Benefits
- Reduced need for repeated needle sticks
- Convenient access for long-term IV therapy
- Decreased risk of irritation and damage to smaller veins
Recovery
- Post-procedure, the patient can typically go home the same day.
- Keep the insertion site clean and dry.
- Follow any specific care instructions provided.
- Regular follow-up appointments to check catheter function and site condition.
- Most patients can resume normal activities soon after the procedure.
Alternatives
- Peripheral IV lines (short-term)
- Midline catheters (medium-term)
- Tunneled central venous catheters or implanted ports (for long-term use)
- Each alternative has its advantages and potential downsides, which should be discussed with your healthcare provider.
Patient Experience
- Mild discomfort or pressure during the procedure.
- You may feel some soreness at the insertion site for a few days.
- Pain management options will be available if needed.
- Generally, patients well tolerate the procedure and adapt quickly to having the PICC in place.