How To Use CPT Code 76936

CPT 76936 describes the use of ultrasound guidance for the diagnosis and compression repair of arterial pseudoaneurysms or arteriovenous fistulae. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 76936?

CPT 76936 can be used to describe the use of ultrasound guidance for the diagnosis and compression repair of arterial pseudoaneurysms or arteriovenous fistulae. This code is used when the provider utilizes duplex scanning, a combination of traditional ultrasound and Doppler, to diagnose the condition and plan the repair by compression. The provider applies compression at the neck of the pseudoaneurysm or the damaged vessel under real-time ultrasound guidance, allowing blood flow through the supplying artery to continue. The compression is maintained until the pseudoaneurysm thromboses and the leakage of blood stops completely.

2. Official Description

The official description of CPT code 76936 is: ‘Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging).’ This code includes the use of diagnostic ultrasound evaluation, compression of the lesion, and imaging.

3. Procedure

1. The provider uses duplex scanning, a combination of traditional ultrasound and Doppler, to diagnose the arterial pseudoaneurysm or arteriovenous fistulae.
2. Based on the diagnosis, the provider plans the repair by compression.
3. Under real-time ultrasound guidance, the provider applies compression at the neck of the pseudoaneurysm or the damaged vessel, allowing blood flow through the supplying artery to continue.
4. The provider maintains continuous pressure on the pseudoaneurysm or the arteriovenous fistula, repeating the process for additional fistulae as needed.
5. After the repair, the provider performs duplex ultrasound scanning to ensure the satisfactory results of the compression repair.

4. Qualifying circumstances

Patients eligible to receive CPT 76936 services are those with arterial pseudoaneurysms or arteriovenous fistulae that require diagnosis and compression repair. The provider must use ultrasound guidance throughout the procedure. The use of duplex scanning, which combines traditional ultrasound with Doppler, is necessary for the diagnosis and planning of the repair. The compression repair is performed under real-time ultrasound guidance, ensuring the safety and effectiveness of the procedure.

5. When to use CPT code 76936

CPT code 76936 should be used when the provider utilizes ultrasound guidance for the diagnosis and compression repair of arterial pseudoaneurysms or arteriovenous fistulae. This code is appropriate when the provider performs duplex scanning, applies compression at the neck of the lesion, and ensures the satisfactory results of the repair through duplex ultrasound scanning. It is important to note that CPT code 76936 should not be reported if only the physician’s interpretation or the technical component of the radiology service is being provided.

6. Documentation requirements

To support a claim for CPT 76936, the provider must document the following information:

• Diagnosis of arterial pseudoaneurysm or arteriovenous fistulae
• Use of duplex scanning for diagnosis and planning of the repair
• Date and duration of the procedure
• Details of the compression repair, including the location and technique used
• Results of the duplex ultrasound scanning performed after the repair
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 76936, ensure that the provider utilizes ultrasound guidance throughout the procedure. If reporting only the physician’s interpretation for the radiology service, append modifier 26 to the radiology code. If reporting only the technical component, append modifier TC to the radiology code. However, be aware that payer policies may exempt hospitals from appending modifier TC. When reporting a global service in which one provider renders both the professional and technical components, do not append a professional or technical modifier to the radiology code.

8. Historical information

CPT 76936 was added to the Current Procedural Terminology system on January 1, 1995, with a code description that included the diagnostic ultrasound evaluation, compression of the lesion, and imaging. On January 1, 2002, the code description was revised to specify the use of ultrasound guidance in the procedure.

9. Examples

1. A provider uses ultrasound guidance to diagnose and perform compression repair on an arterial pseudoaneurysm in the femoral artery.
2. Under ultrasound guidance, a provider diagnoses and performs compression repair on an arteriovenous fistula in the brachial artery.
3. Using duplex scanning, a provider diagnoses and performs compression repair on an arterial pseudoaneurysm in the carotid artery.
4. Under real-time ultrasound guidance, a provider diagnoses and performs compression repair on an arteriovenous fistula in the radial artery.
5. A provider utilizes ultrasound guidance to diagnose and perform compression repair on an arterial pseudoaneurysm in the popliteal artery.
6. Using duplex scanning, a provider diagnoses and performs compression repair on an arteriovenous fistula in the subclavian artery.
7. Under real-time ultrasound guidance, a provider diagnoses and performs compression repair on an arterial pseudoaneurysm in the renal artery.
8. A provider utilizes ultrasound guidance to diagnose and perform compression repair on an arteriovenous fistula in the iliac artery.