Anesthesia Coding Alert

Question: One of our anesthesiologists insists there is an ASA code valued at 1 base unit that crosswalks with CPT® code 76942. I cannot find this anywhere. Do you know the correct code? Or should we report something else?

Montana Subscriber

Answer: The ASA RVG^® assigns base unit values to procedures listed in the CPT^® book. The base value for code 76942 (Ultrasonic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], imaging supervision and interpretation) is not 1. Instead, its base unit value indicator is IC. This designation means the procedure requires “Individual Consideration” before reimbursement is assigned. When this information is reported on a claim form or the electronic equivalent, “1” goes under the units of service. Your anesthesiologist may also be referring to older copies of the RVG^®, which previously listed a 1 under the base value.

Because of the IC indicator, the RVG^® does not provide a crosswalk code for 76942. Get thorough documentation of the service your anesthesiologist provided, and talk with the insurer about specific guidelines for billing the procedure.