Cardiology Coding Alert

Question: I just came across the term “Swan-Ganz catheter” in my cardiologist’s medical documentation. What is this procedure, and which CPT^® code should I report?

Tennessee Subscriber

Answer: A Swan-Ganz catheter, also known as a pulmonary artery or PA catheter, is designed for specific hemodynamic monitoring and central access. Your cardiologist can use the SGC to monitor the patient’s pulmonary artery (PA) pressure, plus measure cardiac output and other cardiovascular functions. This catheter has multiple ports for central circulation access, including a regional anesthesia (RA) port, PA port, CVP port, and possibly the main line or “introducer.”

If your cardiologist places a Swan-Ganz catheter for hemodyamic monitoring purposes, you should report code 93503 (Insertion and placement of flow directed catheter (eg, Swan-Ganz) for monitoring purposes)).

Don’t miss: Because a right heart cath (RHC) is performed with a Swan Ganz catheter, often coders will be confused about whether it is a RHC or really a Swan Ganz catheter insertion for hemodynamic monitoring. A good way for a coder to tell this is a Swan Ganz is inserted, hemodynamics are taken, and at the end of the procedure the catheter is not removed, but left in.

Remember: You should always check the CPT^® guidelines and the Correct Coding Initiative Edits Policy Manual when you are not sure if you can report certain codes together on your Swan-Ganz claims.

For example, you should not report code 93503 in conjunction with codes 36555 (Insertion of non-tunneled centrally inserted central venous catheter; younger than 5 years of age) and 36556 (… age 5 years or older) or codes 36568 (Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, without imaging guidance; younger than 5 years of age) and 36569 (… age 5 years or older) if you cardiologist inserts a single catheter, per the manual.

Additionally, per the CPT^® guidelines, you should never report code 93505 in conjunction with code 0632T (Percutaneous transcatheter ultrasound ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance).

Also, you should never report code 93503 in conjunction with other diagnostic cardiac cath codes, per the CPT^® guidelines.