Amazing tips for Coding Vascular and Non-Vascular Ultrasound Guidance



I am again here to share a few tips about medical coding. Yes, this time we will checkout some CPT codes, which are very important in surgery coding. Yes, we are here to learn about the imaging guidance CPT codes used in diagnostic and interventional radiology. I am talking about the ultrasound guidance CPT codes used in both vascular and non-vascular procedures. The new CPT codes until 2016, mostly includes the imaging guidance procedures. However, still we have many procedure codes, which require coding Ultrasound guidance CPT codes along with the main procedure code. CPT code 76942 and 76937 are used as ultrasound guidance in coding Interventional radiology reports. Let us learn more about these CPT codes.
Amazing tips for Coding Vascular and Non-Vascular Ultrasound Guidance

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When to use CPT code 76942


There are many non-vascular procedure performed percutaneously like breast biopsy, arthrogram, arthrocentesis, Fine Needle aspiration, myelogram, lumbar puncture etc. This exam requires either fluoroscopy, Computed tomography (CT), MRI or ultrasound guidance. For non-vascular procedures, CPT code 76942 is used when ultrasound guidance is used along with primary procedure. For example, if a liver biopsy is performed under ultrasound guidance, the final CPT codes for such procedure will be 47000 and 76942. We have separate ultrasound guidance procedure code (CPT code 76937) which is only for vascular procedure. Hence, do correctly use ultrasound guidance CPT code while coding vascular or non-vascular procedures.

When to use CPT code 76937


As I have already told, CPT code 76937 is specifically used only for vascular procedures. Hence, for procedures like Central venous catheter placement (CVC), PICC placement, angioplasty or stent placement in artery, Fistulogram, Thrombectomy, atherectomy etc. all these exams use ultrasound guidance as imaging guidance. Vascular exams are performed in blood vessels like arteries, veins and fistula. Some of the procedure above includes ultrasound guidance in their primary procedure. For coding CPT code 76937, ultrasound guidance, we need to check three important points to be documented in the medical report.
  1. Patency of blood vessel
  2. Catheter inserted under ultrasound guidance
  3. Images were recorded or images were captured

Once these three phrases have been documented into the vascular medical report, we can assign CPT code 76937 for ultrasound guidance. If any of these phrases is not documented, we should not report this code.

Do and Don’t with CPT code 76942 and 76937


Do not use CPT code 76942 in place of 76937 and vice-versa.
Do check the three points documented above before coding CPT code 76937
Do not use CPT code 76942 and 76937 as primary procedure codes. These codes should be always followed by the major primary procedure code.
Do use CPT code 76942 and 76937, together when a vascular and non-vascular procedure is performed together with the use of ultrasound guidance.
Use CPT Code 76942 and 76937 only once per session.

Read below references for more information:
http://www.hcpro.com/HIM-289707-859/QA-How-should-we-code-fluoroscopy-for-outpatient-procedures.html
https://www.aapc.com/blog/3695-cpt%C2%AE-27096-requires-fluoroscopic-guidance/
http://www.precisionbillinginc.com/coding-updates/103-2015-arthrocentesis-injection-coding-updates
https://www.auanet.org/resources/imaging-radiological-procedures.cfm

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