Anesthesia Coding Alert

Question: Our anesthesiologist recently documented that we should code for a central line, arterial line, and Swan-Ganz catheter during a procedure. It's been a long time since one of our physicians marked all three for a single case; what's the current rule regarding line coding?

Mississippi Subscriber

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

Exception: You can report both lines if your anesthesiologist documents separate locations and placements for the central line and Swan-Ganz catheter. Otherwise, you'll code with 36620 and 93530.

Answers to You Be the Coder and Reader Questions were provided by Scott Groudine, MD, an Albany, N.Y., anesthesiologist; and Marvel J. Hammer, RN, CPC, CCS-P, ACS-PM, CHCO, owner of MJH Consulting in Denver.