76645: US, breast(s) uni or bilat,rea ltime with image documentation Diagnostic Ultra sound- the examination require permanently recorded images with measurementswhensuch measurements are clinically indicated;if sole biometric purposes permanently recorded images are not required(ie 76514, 76516 76519)A final written report should be includedfor patient record purpose too.
(Real time invovlves two dim strucutre an dmotion with time)
76942: Us guidance for needle placement(eg biopsy,aspiration,injection,localization device) imaging supervision and interpretation.. As per the guidelines, "US guidance also require permanently recorded images of the site to be localized, as well as a documented description of the localizing process, either separately or with in the report of the procedure for which the guidance is utilized.
Use of US without thorough evaluation of organ(s) or anatomic region image documentation and written report is not separately reportable"
So from this we infer that both the US diagnostic evaluation and guidance part done by one physician while the other physician visualizing the real time US, is placing the needle /device at the same time- meaning the US evaluation and guidance done by one, and the evaluation and placement(interventional procedure) done by another doctor both necessitating image and reporting.
Fortunately , these two serivces are no where bundled in CPT by descriptionally neither these procedures can be done by one Physician at the same time. The report can be documented separately or combined, but not the real tme US and the interventional procedure done by a same physician at the same time.
So as such , both has to be separately assigned with the more paying interventional procedure 76942 listed first.
well I need to know if the payers are for modifiers for these two professional components
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