Anesthesia Coding Alert

Question: Our anesthesiologist recently checked central line, arterial line, and Swan-Ganz catheter for his extra services during a case. It’s been a long time since one of our physicians marked all three for a single procedure; how should we handle this?

Virginia Subscriber

Answer: You can bill the arterial line with 36620 (Arterial catheterization or cannulation for sampling, monitoring, or transfusion [separate procedure]; percutaneous). The central line (36556, Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older) is included in the Swan-Ganz (93503, Insertion and placement of flow directed catheter [e.g., Swan-Ganz] for monitoring purposes) fee when your physician uses both, which means you won’t normally code for both.

Exception: You can report both lines if your anesthesiologist documents separate locations and placements for the central line and Swan-Ganz catheter. Otherwise, you’ll code with 36620 and 93503.