Ask Dr. Z

Coding guidelines state, "Do not use 93503 in conjunction with other diagnostic cardiac catheterization codes." 1) If a Swan is inserted in the cath lab with other diagnostic procedures, but no pressures are taken, am I correct in thinking that we would have to charge code 93451 because of the coding guidelines? 2) If a right heart catheterization is scheduled with a pericardiocentesis, but pericardiocentsis is not completed and the physician dictates the "catheter was sutured in place for subsequent bedside monitoring", should we charge code 93451 based on the fact that a right heart catheterization was done? Or, does the specific dictation for monitoring make it a Swan insertion?