Radiology Question for the Week of July 11, 2016


Our radiologists use ultrasound for guidance during paracentesis and thoracentesis but do not always save an image to the PACS (picture archiving and communication system). They do include ultrasound guidance in their dictation. Can we still bill CPT codes 32555 and 49083 for these without a saved image?


If permanent images are not kept, you must report the following non-image-guided codes:

32554 Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance

49082 Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance

Also be aware of the following surgery guideline in the CPT book: “When imaging guidance or imaging supervision and interpretation is included in a surgical procedure, guidelines for image documentation and report, included in the guidelines for Radiology (Including Nuclear Medicine and Diagnostic Ultrasound) will apply.”

The CPT ultrasound guidelines say: “Ultrasound guidance procedures also require permanently recorded images of the site to be localized, as well as a documented description of the localization process, either separately or within the report of the procedure for which the guidance is utilized.”

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.