How To Use CPT Code 93503

CPT 93503 describes the insertion and placement of a flow-directed catheter, such as a Swan-Ganz catheter, for monitoring purposes. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 93503?

CPT 93503 can be used to describe the insertion and placement of a flow-directed catheter, specifically a Swan-Ganz catheter, for monitoring purposes. This code is used when a healthcare provider inserts the catheter into a patient’s pulmonary artery, right atrium, right ventricle, and left atrium to directly assess pressure in these areas. The procedure is typically performed on patients with conditions such as heart failure, valvular regurgitation, acute renal failure, pulmonary edema, pulmonary hypertension, shock, and burns.

2. Official Description

The official description of CPT code 93503 is: ‘Insertion and placement of flow-directed catheter (eg, Swan-Ganz) for monitoring purposes.’

3. Procedure

1. The healthcare provider prepares the insertion site by cleansing and administering a local anesthetic.
2. An incision is made in a larger vein, such as the subclavian, internal jugular, brachial, or femoral vein, to access the patient’s circulatory system.
3. The catheter is inserted through the incision and advanced to the pulmonary artery via the right atrium under fluoroscopic guidance.
4. The external end of the catheter is connected to monitoring devices that record pressures at different locations, as well as cardiac output and oxygen saturation levels in the right atrium and right ventricle.

4. Qualifying circumstances

CPT 93503 is typically performed on critically ill patients in intensive care or cardiac care units. The procedure is used to monitor important heart working parameters, including blood pressure, in patients with specific conditions. The points of access for the catheter are commonly the subclavian, internal jugular, brachial, or femoral veins. The catheter may contain multiple lumens or tubes for pressure measurement at different locations in the heart.

5. When to use CPT code 93503

CPT code 93503 should be used when a healthcare provider performs the insertion and placement of a flow-directed catheter, such as a Swan-Ganz catheter, for monitoring purposes. This code is appropriate for patients who require direct assessment of pressure in the pulmonary artery, right atrium, right ventricle, and left atrium. It is important to note that CPT code 93503 should not be reported in conjunction with code 0632T and should be used for the initial insertion and placement of the catheter, not subsequent monitoring.

6. Documentation requirements

To support a claim for CPT code 93503, the healthcare provider must document the following information:

• Reason for the procedure and the patient’s specific condition
• Details of the insertion site preparation and local anesthetic administration
• Specific veins used for catheter insertion
• Fluoroscopic guidance used for correct catheter placement
• Monitoring equipment connected to the external end of the catheter
• Recorded pressures at different lumen locations
• Oxygen saturation levels in the right atrium and right ventricle

7. Billing guidelines

When billing for CPT code 93503, ensure that the procedure involves the insertion and placement of a flow-directed catheter, such as a Swan-Ganz catheter, for monitoring purposes. It is important to follow the specific guidelines for reporting this code and to avoid reporting it with certain other codes. For example, do not report CPT code 93503 in conjunction with code 0632T. Additionally, consider the appropriate use of modifiers if necessary.

8. Historical information

CPT code 93503 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A critically ill patient with heart failure requiring the insertion and placement of a Swan-Ganz catheter for continuous monitoring of pulmonary artery pressure.
2. A patient with pulmonary hypertension undergoing a cardiac procedure that necessitates the insertion and placement of a flow-directed catheter for monitoring purposes.
3. An individual with burns requiring close monitoring of cardiac output and systemic arterial pressures through the insertion and placement of a flow-directed catheter.
4. A patient in shock requiring the direct assessment of pressure in the pulmonary artery, right atrium, right ventricle, and left atrium via the insertion and placement of a Swan-Ganz catheter.
5. An individual with acute renal failure requiring continuous monitoring of pulmonary artery pressure through the insertion and placement of a flow-directed catheter.
6. A patient with valvular regurgitation undergoing a cardiac procedure that necessitates the insertion and placement of a flow-directed catheter for monitoring purposes.
7. An individual with pulmonary edema requiring close monitoring of cardiac output and systemic arterial pressures through the insertion and placement of a flow-directed catheter.
8. A critically ill patient with burns requiring the direct assessment of pressure in the pulmonary artery, right atrium, right ventricle, and left atrium via the insertion and placement of a Swan-Ganz catheter.
9. A patient in shock requiring continuous monitoring of pulmonary artery pressure through the insertion and placement of a flow-directed catheter.