Wiki Swan Ganz & CABG

[ksschroeder]

I have a surgeon who inserts an arterial line and also places a Swan during his CABG's. I have found an STS Coding Newsletter (Summer 2004) in which the society spells out what they consider to be included in the intra-operative cardiothoracic surgical package. Among those specifically spelled out are both arterial line insertion & Swan Ganz catheter insertion.

The surgeon does not want to separately bill the arterial line, but doesn't understand why he shouldn't bill the Swan separately because there is no CCI bundling edit. I have tried to explain that CCI does not contain every edit.

Can anyone help me understand why they insert a Swan Ganz during a CABG? If the patient is on Cardiopulmonary Bypass, what is the purpose of the Swan?

I am also wondering if anyone has found anything on paper that shows the STS may have changed their stance on this since 2004?

Thank you

Kristi

 

[Mojo]

Can anyone help me understand why they insert a Swan Ganz during a CABG? If the patient is on Cardiopulmonary Bypass, what is the purpose of the Swan?

Prior to initiating bypass, the pulmonary artery catheter (PAC - swan ganz), is used to determine the patient's baseline cardiac output, pulmonary wedge and other pressures within the heart as well as the SVO2 that measures the balance of oxygen delivery and consumption. Post bypass, these measurements are used to promote optimum hemodynamics, since many patients are on IV drips to aid in cardiac function.