Look to Location for More Clues on SGC
Question: I’m new to cardiology coding and am a little confused about Swan-Ganz catheter usage. I know they’re used for hemodynamic measurements and monitoring. How do I know if the insertion of a Swan-Ganz catheter is for hemodynamic monitoring or part of another/larger procedure? Illinois Subscriber Answer: The documentation should specify the bigger-picture procedure, but there are some other clues that can help. Swan-Ganz catheters (SGC) are used for hemodynamic monitoring and measurements, like you said, but the situations in which they’re used can offer context. If an SGC is inserted during a cardiac catheterization lab, measurements are taken, and then the catheter is removed, there’s a good chance that there’s a bigger procedure also at play, like a right heart catheterization. If the necessary specifics about the procedure aren’t available in the documentation, you’ll need to query the provider for more information before selecting the relevant procedure code, as this particular service may be bundled into the procedure. If an SGC is inserted at a patient’s bedside (usually in a cardiac care or intensive care unit), and then sutured in place, then it’s probably intended for monitoring, in which case CPT® code 93503 (Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes) may be your best bet for reporting the service. According to the CPT® guidelines, one would report 93503 “for placement of a flow-directed catheter (e.g., Swan-Ganz) performed for hemodynamic monitoring purposes not in conjunction with other catheterization services.” The guidelines also instruct coders to never report 93503 with other diagnostic cardiac catheterization codes. Rachel Dorrell, MA, MS, CPC-A, CPPM, Production Editor, AAPC
