Question Intraoperative ultrasound coding


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Hello! This question is related to intraoperative radiologic guidance in surgery. I work in neurosurgery where we do craniotomies/craniectomies, spinal decompressions/fusions, shunts, etc. We typically code for microscopes 69990 and/or stealth navigation 61781 along with procedures. Recently though one of my MD's said that she's trying to make a case for using intraoperative ultrasound as another imaging option and wants to know is this reimbursable? Correct me if wrong, but looks to me like the code might be 76998. According to chapter 8 pg 21 of the CMS NCCI manual it says that imaging including ultrasound can be separately reimbursable as long as a code descriptor doesn't specifically include radiologic guidance already.

I'm a little hesitant though to just tell the MD this, though, since individual insurance companies may have their own policies about what's bundled/unbundled. So my question is if there's anyone out there who does bill separately for intraoperative ultrasound, and if so then what's been your experience with insurance companies reimbursing?