Anesthesia Coding Alert

Question: Some of our doctors think they can code for ultrasound guidance with line placement. Is there a code to represent ultrasound guidance for 36620 and placements such as CVP and Swan-Ganz?

Nebraska Subscriber

Answer: Your physicians are correct. You can report 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 [List separately in addition to code for primary procedure]) along with line placement codes 36556 (Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older), 93503 (Insertion and placement of flow directed catheter [e.g., Swan-Ganz] for monitoring purposes), or 36620 (Arterial catheterization or cannulation for sampling, monitoring or transfusion [separate procedure]; percutaneous). Be sure to include modifier 26 (Professional component) for proper reimbursement.

Side note: If the hospital owns the ultrasound equipment, code 76942 (Ultrasonic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], imaging supervision and interpretation) with modifier 26 (Professional component) would be the correct was to document ultrasound guidance for nerve block placement for postoperative pain management, unless the nerve block states that guidance is included. Pay attention to site of service rules when reporting ultrasound services when the physician owns the ultrasound equipment.