Radiology Coding Alert

In the September 1999 Radiology Coding Alert article outlining proper coding for the placement, removal and repositioning of central venous (PICC) lines using fluoroscopic or ultrasound guidance, our sources recommended that when a radiologist inserts a catheter under ultrasound guid-ance, CPT 76999 (unlisted ultrasound procedure) could be used. In addition, we reported that if it is medically necessary to remove the catheter under fluoroscopic or ultrasound guidance, the appropriate code 76000 (fluoroscopy [separate procedure], up to one hour physician time, other than 71023 or 71034 [e.g.,cardiac fluoroscopy]) could be used.

A Massachusetts reader questioned this, citing the Interventional Radiology Coding Users Guide by the Society for Cardiovascular and Interventional Radiologists, American College of Radiology and Radiology Business Managers Association, which recommends using 76942 (ultrasonic guidance for needle biopsy, radiological supervision and interpretation) instead of 76999.

Further research has indicated, however, that the code most likely to be reimbursed for this procedure is 76499 (unlisted diagnostic radiologic procedure).

According to Stacey Hall, ART, CPC, CCSP, director of corporate coding and documentation for Medical Management Professionals Inc. in Chattanooga, TN, this is the code recommended most recently by the American Medical Association in its July 1999 edition of the CPT Assistant .

Until July, this reader was correct, Hall says, and in fact, some carriers may accept 76942. Often, organizations like the AMA, ACR and SCVIR dont have the same read on a procedure. Nontheless, it is clear that the AMA is now recommending 76499. To maximize chances of reimbursement, I would suggest that coding professionals call their carriers to see which CPT code is preferred.