Anesthesia Coding Alert

Question: I have an anesthesia provider asking me about this scenario: someone places an introducer into the central vein and charges for it (charge dropped for placement of central line). Sometime later he or someone else floats a Swan-Ganz catheter through the introducer. Can you then code for the Swan-Ganz?

New Jersey Subscriber

Answer: According to the anesthesia guidelines, placing a Swan-Ganz catheter (93503, Insertion and placement of flow directed catheter [e.g., Swan-Ganz] for monitoring purposes) and central line (such as 36556, Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older) through same access site is inclusive. In that situation, only report the Swan-Ganz catheter.

If the line placement is done through a different access site, you can report both lines and append modifier 59 (Distinct procedural service) to the line placement code (36556 in this example). Be sure to have clear documentation of both line places to support submitting both codes.