Wiki Coding Ultrasound 76937-26 with Central Line Placement

[jlcheritage]

can someone answer this question for me please. I have been coding central lines and they indicate in the note that US was used during placement, however also in the note there is this statement: US image on file: no. Can I still code the ultrasound. it clearly states: US Guidance for line placement. I have been billing 36556 and 76937-26 for the MD doing the central line. Can I code the US guidance even though there is no image on file?

Please help

 

[SharonCollachi]

Reporting Ultrasound Guidance for Vascular Access (CPT code 76937)
Recently, Medicare has clarified with AMA/CPT services that CPT code 76937 (Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent real-time ultrasound visualization of vascular needle entry, with permanent recording and reporting ) applies only to venous access procedures. The imaging includes pre-access assessment of venous patency and actual real time visualization of needle passage to the venous lumen.

The descriptor for CPT code 76937 includes all phases of actual guidance, documentation, and reporting required to perform this procedure. Use of CPT code 76937 requires a permanent recorded image(s) of the vascular access site to be included in the patient record as well as a documented description of the process either separately or within the procedure report.

Therefore, it is not appropriate to report CPT code 76937 for ultrasound guidance when ultrasound is utilized only to identify a vein, mark a skin entry point, and proceed with non-guided puncture,. (Note: CPT code 76942 should not be reported with CPT code 76937.)

 

[jlcheritage]

Great, thank you so much for your help. I appreciate it. This is all new coding for me. Thanks again.

 

[tcooper@nmhs.net]

You can use 77001-26 if Fluroscopy was used. The Radiology Dept supplies the Fluroscopy Machine but our Surgeon reads this. The X-Ray Report states that Fluroscopic Guidance for Surgeon in the OR. Hope this helps.