Anesthesia Coding Alert

Question: We are billing ultrasound guidance +76937 x 2 when performing two procedures (such as line placements or pain management procedures). I am trying to ascertain if it is correct to bill 76937 twice, as we are receiving denials stating we are only allowed to bill it once per day. Is this correct?

West Virginia Subscriber

Answer: 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 (List separately in addition to code for primary procedure)) is reported when the provider uses ultrasound for visualization during vascular needle entry. Remember also that since +76937 is an add-on code, you cannot bill it alone. Keep these other points in mind as well, before you file a claim with +76937:

• The CPT^® manual specifies several procedures that you cannot report in conjunction with +76937. These include 37191, 37192, 37193, 37760, 37761, and 76942. If you report +76937 with any of these procedures, your claim will be denied.
• Some codes for pain management injections include visualization. Verify that the procedure isn’t bundled with 76942 (Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation) before reporting both on the same claim.
• If the provider completes more than one procedure (such as multiple pain management injections), you can only bill the ultrasound code once.