# 76645



## sgochoco (Aug 11, 2010)

Does anyone know when it is appropriate to use 76645 during a procedure where 76942 is also used ?  Also,  does 76645 require a separate report ?  If you know the answers to these questions, please let me know and also let me know what your resource was.

Thanks,


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## preserene (Aug 12, 2010)

*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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## sgochoco (Aug 13, 2010)

*Slg*

I'm not sure that I understand your question with regard to the payers. 
Also, could you please tell me where you found the "guidelines" ?

Thanks


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## preserene (Aug 13, 2010)

kindly look into the Diagnostic Ultra Sound category guidelines


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