5/23/2014 – Surgeon Wants Two CVP Lines

Question: Cardiologists are asking us to place two CVP lines during coronary artery bypass (CABG) procedures. Is there a way to bill this and get paid for the second line?


Answer: Yes, but your documentation must support the second line by showing there were two separate access sites and the reason for the second line.


The American Society of Anesthesiologists’ states the following on intravascular catheterization procedures: “The technique is appropriately used for patients who experience significant blood or fluid loss during surgery. Additional indications for placement of a central venous catheter are to secure a reliable means for rapid administration of large volumes of fluid or blood, to provide access in the absence of peripheral venous access or to allow for administration of certain medications that are most safely and effectively administered directly into the central venous circulation.”


In regards to bundling issues, the ASA states: “Occasionally two separate access sites to the central circulation are required. One site is used for the measurement of cardiovascular function, the other dedicated to the administration of medications or fluids. This could result in charges for two 36556 codes or one 36556 and one 93503.”


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