Coding for locating a vein and marking it for mapping purposes

Q.

How would you code the following situation? The radiologist was requested to mark the site for cannulation of a dialysis graft. Sonographic evaluation of the main outflow vein of the basilic vein, of the left upper arm hemodialysis fistula revealed wide patency of the vein which is large in caliber measuring up to 9 mm in diameter. The most superficial portion is approximately 5 mm deep to the skin. Cutaneous marks were placed for mapping purposes using ultrasound guidance. Images were stored for documentation.

A.

We recommend reporting CPT^® code 76882. Because the physician was only locating the vein and marking it, the extremity soft tissue ultrasound would be most appropriate. The code and full description are as follows:

76882 Ultrasound, limited, joint or other nonvascular extremity structure(s) (e.g., joint space, peri-articular tendon[s], muscle[s], nerve[s], other soft tissue structure[s], or soft tissue mass[es]), real-time with image documentation