Cardiology Coding Alert

Question: Can I charge for a central venous access placement and a Swan-Ganz catheter placement separately, or are they bundled together? Oregon Subscriber Answer: The national Correct Coding Initiative (CCI), version 8.2, does not bundle central venous access placement (36488*, Placement of central venous catheter [subclavian, jugular, or other vein] [e.g., for central venous pressure, hyperalimentation, hemodialysis, or chemotherapy]; percutaneous, age 2 years or under; or 36489, percutaneous, over age 2) with Swan-Ganz catheter placement (93503, Insertion and placement of flow directed catheter [e.g., Swan-Ganz] for monitoring purposes). Therefore, they can be billed together when performed during the same session. In addition, there would be no need to append the codes with a modifier. However, if the central line is used as an introducer through which the Swan-Ganz in inserted, you should not report central venous access placement separately. Only 93503 should be billed.