Wiki Insertion of Arterial Line for Monitoring

[20Hiker16]

Can someone please give me their opinion on coding arterial line placement when specifically done for blood pressure monitoring purposes?


Some coders have the understanding of coding only for the monitoring arterial line that would be coded 4A033B1. Some are saying to code the "device" as well (03H (Upper arteries) or the 04H (Lower arteries) table), by adding this code, the DRG changes significantly to and OR procedure.

My concern is that the "device" is not being inserted into the body of the patient. The procedure, itself, only reflects the insertion of the arterial line. The purpose is documented for monitoring blood pressures & ABG's.

Is the Arterial Line the Monitoring Device? If so, why would I code both? Do I need to code both?

Thank you.

 

[vlh12115]

IP Coding for Arterial Line monitoring

The question: "Is the Arterial Line the Monitoring Device? If so, why would I code both? Do I need to code both?"

Based on ICD-10-PCS guidelines, code 4A133B1 reports insertion of an arterial line for continuous physiological monitoring. This is not an OR procedure that will shift your DRG. The arterial catheter insertion facilitates continuous BP monitoring & serial blood sampling via a peripheral artery; therefore, coding the insertion separately, would seem to violate Root Operation Guideline B3.1b regarding "Components of a procedure...".

The monitoring device is the pressure transducer, which is connected, with long clear, small bore tubing, to the arterial catheter placed in the peripheral artery. The pressure transducer is what allows the BP to be continuously displayed on the monitors.

The above information is only my opinion based on my clinical experience in the critical care unit & studying medical coding.

Vickie Wilkerson
Secretary 2016
APC-Richardson Chapter

 

[20Hiker16]

My same thoughts...thank you for your participation.

The facility administration had done some extensive research on this subject and we have been instructed to code only the insertion of the arterial line for monitoring. No device code. (So, Vickie's code, 4A133B1 (depending on the artery used) is the only code to report.) This had been a controversial subject in the beginning of PCS as many were also coding a device.