# US guidance for vascular access ??



## Rita Bartholomew (Dec 18, 2012)

Ultrasound was used for vascular access in right groin (common femoral artery) for a left lower extremity revascularization procedure.  I see that CPT 76937 can be coded if there is medical necessity.   One of my vascular surgeons seems to be using it for all of his similar procedures and wants to assign 76937 regularly.  Is this appropriate?  What would constitute medical necessity?  The images are being stored.  Here is a sample:

_DESCRIPTION OF PROCEDURE:  The patient was taken to the cardiac catheterization laboratory, where the skin of the groin area was prepared and draped in a standard sterile fashion.  I then called a time-out for correct patient and procedural identification per Xxxxxxx Hospital protocol.  *Next, under color-flow duplex ultrasound guidance, I accessed the right common femoral artery.  Images were archived to the Xxxxxx XXXX system.  The right common femoral artery was noted to be densely calcified. * A 0.018-inch Micro-Access system was used under local anesthesia._


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## donnajrichmond (Dec 20, 2012)

Rita Bartholomew said:


> Ultrasound was used for vascular access in right groin (common femoral artery) for a left lower extremity revascularization procedure.  I see that CPT 76937 can be coded if there is medical necessity.   One of my vascular surgeons seems to be using it for all of his similar procedures and wants to assign 76937 regularly.  Is this appropriate?  What would constitute medical necessity?  The images are being stored.  Here is a sample:
> 
> _DESCRIPTION OF PROCEDURE:  The patient was taken to the cardiac catheterization laboratory, where the skin of the groin area was prepared and draped in a standard sterile fashion.  I then called a time-out for correct patient and procedural identification per Xxxxxxx Hospital protocol.  *Next, under color-flow duplex ultrasound guidance, I accessed the right common femoral artery.  Images were archived to the Xxxxxx XXXX system.  The right common femoral artery was noted to be densely calcified. * A 0.018-inch Micro-Access system was used under local anesthesia._



Ultrasound guidance for vascular access is becoming standard of care so expect to see this more frequently.  As long as the documentation requirements are met, I would code it each time.  Each payer will determine whether or not to pay it.


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## kbazarte@yahoo.com (Feb 1, 2013)

My Interventional Radiologist also uses US guidance for vascular access and as long as it is properly documented you can bill.  We had an independent audit and the company also confirmed that yes it can be billed as long as it meets all the requirements.


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