Ask Dr. Z

This is for physician coding. It is unknown who originally placed the midline or where the tip of the midline terminated. What CPT code would we use when they exchange a midline for a PICC line through the same access site? What CPT code would we use when they exchange a midline for another midline through the same access site? "A left-sided midline catheter was in place prior to beginning the procedure. The LEFT upper arm was prepped and draped in the usual sterile fashion. A stainless steel straight wire was advanced through the midline catheter, and exchange was made for a 5 French double-lumen power PICC catheter. The PICC catheter was positioned at the superior caval-atrial junction. Fluoroscopy was used to confirm final catheter position. The catheter was secured in place. IMPRESSION: Successful LEFT arm PICC line placement (midline catheter exchange)."