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Pulmonology Coding Alert

Reader Question:

Swan-Ganz Catheter

Published on Mon Dec 31, 2012

Question: One of our doctors performed a Swan-Ganz catheter procedure, but complications ensued, and we needed a radiologist present. We also needed to perform a fluoroscopy. The whole procedure took two and a half hours. Later in the day, the patient needed critical care. Can I use a prolonged service code in this case?

Idaho Subscriber

Answer: When performing such services as critical care and prolonged services along with separately billable procedures, you must understand that the time spent performing the procedure isnt billable as part of the time of critical care or prolonged services:

99356 (prolonged physician service in the inpatient setting, requiring direct [face-to-face] patient contact beyond the usual service [e.g., maternal fetal monitoring for high risk delivery or other physiological monitoring, prolonged care of an acutely ill inpatient]; first hour)

99357 (... [...]
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