Anesthesia Coding Alert

Question: One of our anesthesia providers has asked about billing for ultrasound guidance (76942) when he places an IV line for fluids. I know the IV line is part of the anesthesia service and there is no separate billing for the IV, but can we bill 76942 the guidance in this situation?

New York Subscriber

Answer: No, you cannot bill an ultrasound code such as 76942 (Ultrasonic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], imaging supervision and interpretation) if you’re not also reporting a companion procedure code for it. Anesthesia codes are not considered companion codes for ultrasound.

Different scenario: If you were able to code the IV placement with guidance, you would submit 36620 (Arterial catheterization or cannulation for sampling, monitoring or transfusion [separate procedure]; percutaneous) or 36556 (Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older) with 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]).