Right Heart Catheterization with Swan-Ganz


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Looking for HELP on coding question.

Our cardiologist performed a Right Heart Catheterization with insertion and placement of Swan-Ganz for monitoring purposes.

Can we code for both the Right Heart Cath (93501) & Swan-Ganz placement (93503)? Reimbursement for placing the Swan-Ganz is significantly less than the Right Heart Cath. If I can only charge for one my choice would be Right Heart Cath.

Any advice.

Revenue Questions in Houston.


In reply to your question, You can only bill for the swaz-ganz with a modifier 59 depending on your operative report.
This is from my Medicare carrier and how I have always coded a Swan-Ganz. There could be an exception though depending on the report as the last post states.

Swan Ganz Placement (93503). When a catheter is placed in the right heart for medically
necessary monitoring purposes, the code 93503 must be reported. The codes describing a right
heart catheterization (e.g., 93501) are used only for medically necessary diagnostic procedures.
The code 93503 includes:
a. Anesthesia or sedation.
b. The insertion of the flow-directed catheter.
c. The recording of intracardiac and intravascular pressures.
d. Obtaining blood samples.
e. The use of data obtained from measurements of the catheter.
RHC with Swanz Cath

I bill this way

93503 ( I do not use a modifier on this code )

Normal reimbursement 487.59 from insurance
Normal coinsurance 96.08 from patient

I hope this helps.
Hi this is Carolyn McLaughlin with The B'CPC(The Baltimore chapter of Professional Coders) in answer to your question, per the 2008 Ingenix Facility Guide for Interventional Radiology, page 143 #6 it says(quote=Report separately the placement of a flow directed catheter (swan ganz) for the purpose of hemodynamic monitoring when performed during cardiac catheterization)

there have been so many changes in 2008 for coding cardiac procedures, as of 2008 Medicare pays about $400.00 for the placement of the swan ganz during outpatient cardiac caths. You can reach me via our website (bcpcmd.com)

Good Luck
Legal documentation for heath catherization

Hi Carolyn,

I have sat in serveral cardlology coding seminars and I remember the question being asked if the report that the cath systems uses is considered not a legal documnet. I have to find in writing to plead my case w/physician. Can you help me?

Carol Latkovic, CPC
University Hospitals