Radiology Coding Alert

Question: Can our ultrasound technician compress the artery during the pseudoaneurysm repair (76936, Ultrasound guided compression repair of arterial pseudo-aneurysm or arteriovenous fistulae [includes diagnostic ultrasound evaluation, compression of lesion and imaging]) after showing the radiologist the source of bleeding, or must the physician personally perform it?

Pennsylvania Subscriber

Answer: Medicare requires the physician's "personal supervision" during this service, which means that the physician must be in the room during the procedure but does not have to perform the procedure personally. If you are billing this service to Medicare, however, note that most carriers consider it a noncovered service. The local medical review policy (LMRP) for your Part B carrier, HGS Administrators, states, "The efficacy and applicability of ultrasound guided repair of arterial pseudoaneurysm or arteriovenous fistulae has not been established. This service is not reimbursable at this time." You should ask your patients to sign an advance beneficiary notice (ABN) before you perform the procedure, and explain that they will be responsible for paying you directly in the likely event that Medicare denies the service.