Pulmonology Coding Alert

Question: Can I report 36556 and 93503 together on the same day?


Texas Subscriber

Answer: National Correct Coding Initiative does not bundle 36556 (Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older) and 93503 (Insertion and placement of flow directed catheter [eg, Swan-Ganz] for monitoring purposes), so you can report both codes on the same day. Some carriers may require that you append modifier 59 (Distinct procedural service) to indicate that the procedures were in fact distinctly separate.

Physicians consider the insertion of a central line (36556) to be an integral part of inserting a Swan-Ganz catheter (93503). In certain uncommon circumstances, however, the physician might need to insert a central line in one region of the body and the Swan-Ganz in another area. In this case, you would certainly want to report both procedures.

Tip: In addition, when a physician inserts a hemodialysis catheter you would report code 36556. This procedure may occur on the same day as a Swan-Ganz catheter insertion, so you would report both 36556 and 93503.