# Swan-Ganz 93503



## ammontagano (Mar 23, 2012)

Patient presents for diagnositic right heart catheterization. * A Swan-Ganz cath was advanced in a retrograde manner while monitoring pressures.  *  Coronary angiography was performed using JR-JL-4 and angled pigtail catheter.  There were no complications and minimal blood loss.  Upon completion of the procedure, sheaths were removed and Angio-Seal was deployed.

This is what was billed:

93460-26
93503-59

I disagree with the billing of 93503 because the intent of a Swan Ganz cath is that it is left in in order to measure intra-cardiac pressures over a period of time.  Any thoughts?


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## bcollier (Mar 23, 2012)

In the procedural coding expert book, it states not to use 93503 with 93460.


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## ammontagano (Mar 23, 2012)

Per CCI edits, modifier -59 is allowed.  But under what circumstance?


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## sashka (Mar 25, 2012)

*93456 for the coronary angiogram with right heart cath*

93460 is for left and right heart cath and coronary angiogram.  
Per ZHealth Publishing, there is no add'l reimbursement for leaving a cath in place for monitoring at the conclusion of a rt heart cath or for the introduction of a Swan-Ganz type cath at the time of a right heart cath.
The only code I'd use is 93456.


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