Anesthesia Coding Alert

Question: One of our anesthesia providers asked me about how to code this scenario: Someone places an introducer into the patient’s central vein and charges for it (charge dropped for placement of central line). Later, the same provider floats a Swan-Ganz catheter through the introducer. Are you allowed to code for the Swan-Ganz?

Kansas Subscriber

Answer: According to anesthesia coding guidelines, Swan-Ganz and central line placement through the same access site are inclusive. You should only report the Swan-Ganz line with 93503 (Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes).

If the line placements are at different sites, you can report both codes – 93505 and 36556 (Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older). Append modifier 59 (Distinct procedural service) and include clear documentation of why you’re billing for both lines.