Anesthesia Coding Alert

Question: Our physician inserted an introducer, but not the line. How should I code this?


Maine Subscriber

Answer: Coders differ on the best way to handle this situation. Some coders recommend reporting 93503 (Insertion and placement of flow-directed catheter [e.g., Swan-Ganz] for monitoring purposes), which includes both the Swan-Ganz and central venous (CV) lines, unless the physician places them during different encounters or at different sites.
 
However, other coders say you should not bill this as a Swan-Ganz placement because the physician did not "float" a catheter. The physician can insert a Swan-Ganz introducer and use it for central access. It sounds as if the physician did this in your case, so these coders say you should bill it as a CVP line insertion. Verify the procedure with the physician and report the appropriate code from central venous access device insertion codes 36555-36571.