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Lori Posted Tue 23rd of January, 2018 12:45:46 PM
I have a provider who is billing 93458. Can we add a 76937 for the ultrasound guidance? We are having a hard time getting this paid as the payers are coming back stating that "the primary code has not been billed". What are the primary codes for the 76937 add-on code?
SuperCoder Answered Wed 24th of January, 2018 01:33:11 AM


If all the requirements for assignment of CPT code 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)} are met, you can assign it. As noted in the code description, these requirements include more than recording and documentation. Under the outpatient prospective payment system (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 CPT 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}. I am unable to find exact updated list of primary codes for CPT 76937 but some of them are: 36555-36585, 36481,36000, 36012, 36010, 36245, 36005, 36620, 36011, 36500, 36870, 36581, 36145, 36120, 36200


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