Cardiology Coding Alert

Question: I have been reporting 76937 for ultrasound access during a heart cath. If we use the ultrasound on every patient just to make the access easier and not because we can't find a pulse, can I still report it?


Florida Subscriber


Answer: Your cardiologist may perform the ultrasound access as good medical practice. Think of other examples, such as a chest x-ray after placing a chest tube.

You won't receive reimbursement for those exams, but it is good medical practice for your cardiologist to perform them. 

You wouldn't report +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]) because the service represented by this code isn't really part of a procedure.
 
If you are going to be doing this routinely, you should remember that this could red flag your practice for an audit. Having an inordinate number of claims for that CPT code in conjunction with a catheter is a good way to attract an audit. It sounds as if this is just a common part of the procedure when the cardiologist is accessing, and thus you don't have any medical necessity.