Cardiology Question for the Week of November 2, 2015

Question:

Question 

Can we charge 76937 for ultrasound guidance for vascular access with 93458 for left heart catheterization if we have permanent recording with the needle placement and it is documented?

Answer

If all the requirements for assignment of 76937 are met, you can assign it. As noted in the code description below, these requirements include more than recording and documentation.

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)

Under the OPPS, Medicare does not pay for code 76937, but it should be assigned if the procedure is performed in accordance with the requirements listed. Some other payers limit the use of 76937 to central venous device access, but according to the American Medical Association, it can be used with other vascular procedures as well unless it is specifically prohibited in guidelines such as with the following code: 

37191    Insertion of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed.

Answer: