Coding for ultrasound guidance for vascular access

Q.

Does CPT^® code 36902 include ultrasound guidance or not?  The CPT book just states “all imaging,” so we are not clear on the answer.

A.

If you are talking about CPT code 76937 for US guidance for vascular access, then it may be separately reported. The guidelines in the CPT book state “Ultrasound guidance for puncture of the dialysis circuit access is not typically performed and is not included in 36901, 36902, 36903, 36904, 36905, 36906. However, in the case of a new (immature) or failing AVF, ultrasound may be necessary to safely and effectively puncture the dialysis circuit for evaluation, and this may be reported separately with 76937 if all the appropriate elements for reporting 76937 are performed and documented.”