General Surgery Coding Alert

Question: I have an op report that documents a central line, arterial line, and a Swan-Ganz catheter. Can we report three separate procedures, or are there some bundling issues I need to be aware of?

Wisconsin Subscriber

Answer: You can bill the arterial line as 36620 (Arterial catheterization or cannulation for sampling, monitoring, or transfusion [separate procedure]; percutaneous). The Swan-Ganz (93503, Insertion and placement of flow directed catheter [e.g., Swan-Ganz] for monitoring purposes) includes the central line (36556, Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older) fee when your surgeon uses both. You shouldn’t normally code for both 93503 and 36556.

Exception: You can report both the central line and the Swan-Ganz catheter if your surgeon documents separate locations and placements for the two.

Bottom line: Without documentation of separate anatomic sites, you should code this case as 36620 and 93503.