Wiki US guidance for A-line 76937

nlaaron

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HI can anyone tell me if 76937 is separately paid by medicare and medicaid if done with an A-line or Central line placment with all the proper documentation on file, which includes US report? Thanks.
 
This came from the American College of Emergency Physicians web site.
FAQ 6. I use ultrasound frequently for placing central lines. What are the requirements for billing for the ultrasound?
Code (76937) is used specifically for central venous access with ultrasound guidance. The current CPT description is:

"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."

There are several unique aspects of the central venous and peripheral vascular access with ultrasound guidance code of which users must be aware. The first is that the code is intended for use only when the ultrasound is used with the "dynamic" technique, as opposed to the "static" technique which is not considered a reimbursable service.

The static technique utilizes the ultrasound to identify the vessel, but is not used during line placement. In the dynamic technique the physician uses the ultrasound throughout the procedure from initial identification of the vessel through direct visualization of the needle entering the vessel. A recorded image of the procedure is required for coding.

When coding a central line placement under direct dynamic visualization with ultrasound it is appropriate to code 76937 for vascular ultrasound guidance and 36556 for the adult central venous line placement.

It would appear that a dynamic technique would require an archived ultrasound image with needle placement.
Good Luck!
 
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