Anesthesia Coding Alert

Question: Our anesthesiologist inserted a Cordis catheter, which he says is similar to a Swan-Ganz. He used it for monitoring purposes (again, similar to the Swan-Ganz). How should I code for this catheter?


Illinois Subscriber

Answer: A Cordis "introducer" is a central venous catheter that the anesthesiologist can use to float the Swan-Ganz catheter through. Because the Cordis catheter accesses the central circulation, code it with 36556 (Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older).
 
However, some coders believe it's appropriate to report 93503 (Insertion and placement of flow directed catheter [e.g., Swan-Ganz] for monitoring purposes) instead because the Swan-Ganz catheter goes through the Cordis, and the Swan-Ganz has more base units.

Because of the differences in opinion, check with the carrier for a policy verification before submitting the claim.

You Be the Coder and Reader Questions were reviewed by Tonia Raley, CPC, with Medical Information Management Solutions in Phoenix.