Ask Dr. Z

Is it appropriate to report vascular ultrasound guidance (76937) during placement of a Swan-Ganz/pulmonary artery catheter (93503)? For clarity, the vascular ultrasound guidance is used to confirm vessel patency and gain access to the vessel using real-time ultrasound guidance when placing the central venous introducer, and the pulmonary artery catheter is then floated through that introducer. I know the central venous introducer is bundled. I can't find any guidelines to prohibit reporting code 76937 with 93503 though. I see from NCCI that 76937 is bundled with cardiac catheterization, PCIs, and EP codes like pacemakers and defibrillators, but the Swan-Ganz is not specifically addressed.