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Ask-A-Consultant: New CPT Code 76937 - Add-on for US Guidance for Vascular Access

Q:

The new code for radiology 76937, it states ultrasound guidance for procedures. However, this code includes permanent recording and reporting. Do they mean permanent recording that you actually take a film of the area with the ultrasound equipment? Most only use the ultrasound for the guidance

A:

The AMA guide, “CPT “Changes for 2004, An Insider’s View” gives the specialty rationale for adding code +76937. It is to be used in conjunction with vascular access codes for which ultrasound guidance is not inherent, including the new central venous access procedures (CPT 36555-36585). It is not to be used with CPT 76986 – “Ultrasound guidance, intraoperative”.

A clinical example is also provided for use of this new code. Recording of the venous sites and documentation of the procedure in the patient record is required to use this code. Procedures where Ultrasound is used only to identify a vein, mark a skin entry point, and proceed with non-guided puncture should not be reported with 76937. The clinical example is:

“A patient requires internal jugular (IJ) central venous catheter placement. The physician decides that ultrasound guidance is necessary for safe IJ venous access.”

The procedure includes the following – “Potential access sites are examined with ultrasound and an acceptable patent access site selected. Permanent documentation of sites is recorded. After sterile field has been established, the US probe is covered with sterile sleeve. Aquasonic gel is applied and real-time US is performed monitoring the advancement of the access needle into the lumen of the selected vessel. This position is also recorded. Description of the guidance process is included in the final procedure report.”
 

Karen M. Beard, CPC
Senior Associate

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