Cardiology Coding Alert

Question: What is the difference between 93501 (right heart cath) and 93503 (insertion and placement of flow-directed catheters, e.g. Swan-Ganz for monitoring purposes)? Our doctors sometimes refer to both as a right heart cath.

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Answer: In both procedures, a catheter is threaded to the right heart, often through the femoral vein. But with the 93503, no injection is done; only measurements are taken. Another difference is that the 93503 is usually performed at the bedside in a critical care unit, not in the cardiology cath lab. The right heart cath, explains the American College of Cardiology Guide to CPT 1999, is primarily for diagnostic purposes. While a flow-directed catheter is for monitoring purposes in an intensive care setting and is done to monitor critically ill patients or preoperatively to allow monitoring of hemodynamics during surgery.

Read the documentation carefully to determine whether to code a 93503 or 93501-26 (professional component) as the RVUs are somewhat different (5.76 and 6.89 respectively).