Description of CPT 76942: The CPT Code 76942 is used for all ultrasonic guided needle placements, including biopsy, aspiration and injection, and is a CPT specific code for ultrasonic guided procedures.
This code is not used for vascular surgery.
The billing guidelines for CPT code 76942 can be found here.
CPT 76937 Add-On Code
Several ultrasonic procedures require the addition of a code. It adds a code to the ultrasound guidance for vascular procedures, and CPT specific codes are included for ultrasound guidance.
Ultrasound Guided Lumbar Puncture Receives
Pericardiocentesis has its own additional code of 76930 that goes with procedural CPT Code 33010. CPT codes for Ultrasound guided diagnostic arterial puncture are CPT 36600 and CPT 76937.
The untunneled central venous catheter insertion in patients aged five years and over is recorded with the CPT coede 36556 or CPT Code 76937.
For other procedures (besides CPT 76942) , a single code is used and the code description includes an ultrasound guidance. CPT code 32555 is used for ultrasonic thoracesis and CPT code 49083 for ultrasonic paracesis
Only one code will be charged for serial limited examinations carried out on the same day. According to CPT 4, it is permissible for two different doctors to report a restricted or complete ultrasound on the same day and to document the medical need for the restricted or completed ultrasound.
For example, if the limited study is inconclusive or abnormal, there is no need for a full study.
However, payers and individual policies regulate reimbursement and it is possible that a limited study may be rejected in favour of a full ultrasound.
Modifiers Used For Ultrasound Guided Procedures
Include modifier 26 if the hospital owns the POCUS (point-of-care ultrasound) ultrasound equipment, but do not add modifier 26 if the equipment belongs to the hospitalist or group.
Add modifider 25 to the code for any E/M services performed on the same day as POCUS.
Ultrasound Guided Procedures
CPT 36556 + CPT 76937: Central venous catheter.
CPT 36556 + CPT 76937: Arterial puncture.
CPT 33010 + CPT 76930: Pericardiocentesis.
CPT 62270 + CPT 76942: Lumbar puncture
CPT 20604/20606/20611: Arthrocentesis