Anesthesia Coding Alert

Question: One of our new physicians said we are allowed to charge for both the placement of line and ultrasound (US) guidance when utilized. Is this true, and do you know any sources or information that support this?

Minnesota Subscriber

Answer: Your new physician is correct. The AMA unbundled ultrasound guidance from several line and catheter placement codes a few years ago. If you check the National Correct Coding Initiative (NCCI) edits, you will find these services are no longer bundled and may be reported separately, as long as documentation supports the spirit of the ultrasound code description.

For example, you can report 36620 (Arterial catheterization or cannulation for sampling, monitoring or transfusion …) for an arterial line and add-on code +76937 (Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting …) appended with modifier 26 (Professional component) when documentation includes a permanent recorded image of the vascular access site and proper reporting.

You can find documentation suggestions clearly outlined at www.anesthesiallc.com/publications/anesthesia-provider-news-ealerts/1268-anesthesia-and-invasive-line-ultrasound-a-fresh-look-at-billing-and-documentation.