Anesthesia Coding Alert

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

Maine Subscriber

Answer: Your most accurate options lie with central venous access device insertion codes 36555-36571.

Controversy: Some coders recommend reporting 93503 (Insertion and placement of flow-directed catheter [e.g., Swan-Ganz] for monitoring purposes) for the service you describe. Code 93503 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 a CVP (central venous pressure) line insertion. Verify the procedure with the physician. If he or she only placed the introducer, choose from 36555-36571.