Radiology Coding Alert

Question: When performing an invasive procedure (e.g., CPT 75605 , aortography, thoracic, by serialography, radiological supervision and interpretation), the radiologist may use ultrasound to localize the vessel he wishes to stick for instance, if the patient has poor venous or arterial pulses. What procedural code should we use to bill for the ultrasound guidance to localize a vessel? Should any modifiers be associated with the code?

Mickey Montero
St. Louis, Mo.

Answer: According to an article in the July 1999 CPT Assistant, published by the American Medical Association, coders are directed to use 76499 (unlisted diagnostic radiologic procedure) for ultrasound guidance. There is no need to append a modifier.