Week of December 9, 2013
Is the procedure described by code 93503 the same as the procedure described by 93451?
As its description indicates, code 93503 is used only for the insertion and placement of a flow-directed catheter, such as Swan-Ganz, for the purpose of hemodynamic monitoring. This procedure is very similar to a right heart catheterization (RHC), however, the Swan-Ganz is usually performed at bedside and a true diagnostic RHC is performed in the cath lab.
The service described by code 93503 is not typically performed in the cardiac catheterization laboratory, which is what distinguishes it from code 93451 (right heart catheterization including measurements of oxygen saturation and cardiac output, when performed). Placement of a flow-directed catheter for monitoring in an intensive care setting is done to monitor critically ill patients, or preoperatively to allow monitoring of hemodynamics during surgery. The right heart catheterization described by code 93451 is diagnostic in nature and often performed in conjunction with other cardiac catheterization procedures.
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