Question PA Line Removal

ablythe

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How do we code for PA line removal? A patient came to the cath lab solely for this purpose. Nothing else was performed.
 

thomas7331

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Per CPT Assistant, the non-incisional removal of vascular catheters is not separately reportable and is considered inclusive to the E/M service during which it is performed.
 

ablythe

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Per CPT Assistant, the non-incisional removal of vascular catheters is not separately reportable and is considered inclusive to the E/M service during which it is performed.
It was not performed during an E/M though. The patient was brought to the cath lab procedure room just to have the PA line removed. Is there any way to capture this work?
 

thomas7331

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It was not performed during an E/M though. The patient was brought to the cath lab procedure room just to have the PA line removed. Is there any way to capture this work?
Why was a trip to the cath lab necessary for this? Perhaps if you could share the operative report of physician documentation of the procedure and it might give some insight as to how it could be coded.
 

ablythe

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Cardiac Catheterization Report
KNIGHT CARDIAC CATHETERIZATION LABORATORY FINAL REPORT


INDICATION(S) FOR PRIMARY, SECONDARY PROCEDURE:
XXX with a hx of HFrEF (LVEF 30-40%), pAF (on
apixaban, amio, metop), CAD (STEMI stents to LAD, D1, LCx 9/2018
MAH), ESRD on HD, FVL, and DVT, recent anginal symptoms prompting
LHC at OSH demonstrating critical CAD with significant left main and RCA
disease turned down at OSH by Ctx and interventional cards [felt
unsuitable for impella due to vascular access] who presents with HGAVB
and cardiogenic shock s/p TPW and RHC demonstrating indices c/w
cardiogenic shock, remaining critically ill, s/p intubation and ventilation
remaining on inotropes and pressors. XXX is now planned for PA line
removal under flouroscopic guidance.

DIAGNOSTIC SUMMARY:
-- PA line removed under flouroscopic guidance with no change in position
of R IJ V TPW.

PATIENT CONDITION, PLAN AND RECOMMENDATIONS:
-- Return to Ellison 9

PROCEDURES:
PA Line removal

DIAGNOSTIC TECHNIQUE:

The Swan-Ganz catheter was removed under fluoroscopy without incident.
There was no change in the position of the temp pacing wire.

______________________________________________________________________________________________

I have not seen this situation before.

Thanks for your time.
 
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