76937 post audit PLEASE HELP

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we always use 76937 on ports, cvp's etc. Recent audit recommended we also use 76937 for vascular procedures such as diagnostic angio's, stenting procedures, embolization procedures, ie. ANY time we use u/s guidance for vascular access. I have searched CMS and FCSO and was told by FCSO we can submitt and SEE if it gets paid. Does anyone have info on this or can direct me to it. PLEASE also email me at kbazarte@yahoo.com
 

donnajrichmond

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we always use 76937 on ports, cvp's etc. Recent audit recommended we also use 76937 for vascular procedures such as diagnostic angio's, stenting procedures, embolization procedures, ie. ANY time we use u/s guidance for vascular access. I have searched CMS and FCSO and was told by FCSO we can submitt and SEE if it gets paid. Does anyone have info on this or can direct me to it. PLEASE also email me at kbazarte@yahoo.com
76937 is not limited to central venous access. It can be used when medically necessary for any vascular access, including angiogram, etc., unless it is specifically prohibited. As long as your doctor does and documents the requirements of the code.

CPT Assistant, Jan 2009 has a Q & A concerning IVC filter placement and it discusses using 76937 in that case.
ACR Coding Source, Sept/Oct 2011 has a Q & A ultrasound guidance for access for renal angioplasty, and say to use 76937.
SIR has a FAQ in their IR coding guide that where this question was asked and answered yes, for vascular access when ultrasound is not an inherent part of the procedure.

(There are other references, but these should do.)
Some payers do limit it, but the code descriptor does not limit it to central venous access. (for comparison, see 77001 which does specify central venous access.)
 

donnajrichmond

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The new vena cava filter codes specifically include ultrasound guidance in the code description, so you cannot code 76937 with those. (you could with the old IVC filter codes.)
Also, when you look at 76937 in the CPT book, there is a parenthetical note prohibiting its use with 37191, 37192, 37193, 37760, 37761, 76942.
You can code 76937 with UFE, TIPS, revascularization, etc.
 

donnajrichmond

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by the way, I highly recommend CPT Changes - either by buying the book each year, or subscribing to an online product that allows you access to back issues. When new codes are created, the society (or whomever asked for the new code) creates a scenario/sample case to explain the code. Those are in CPT Changes. Those tell you what the code includes. It can be a great help to understanding new codes.
 
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