Billing for handheld ultrasound

Q.

Can we bill for an ultrasound done with a hand-held device? Are there special guidelines for this?  I know that Clinical Examples in Radiology (CER) noted, in 2012, that a hand-held device could not be used when performing US guidance for vascular access (i.e., CPT code 76937).

A.

As long as the device can produce permanent imaging, and the imaging meets the requirements of a particular code, a hand-held device may be used and the procedure coded. Clinical Examples in Radiology noted this in a Q&A from 2004. In response to a question as to whether it was appropriate to report a diagnostic ultrasound code if a hand-held ultrasound device was used, CER gave the following answer.

“CPT codes are developed for the reporting of physician services or procedures and the type of equipment or size of the unit used (stationary vs hand-held) is not the determining factor in the choice of the appropriate CPT code. The choice of the appropriate ultrasound code should be based on the anatomy studied (eg, abdomen, breast, extremity).”

The 2012 Clinical Examples in Radiology article that you reference doesn’t say you can’t use a hand-held device, just that should a hand-held device be used you still have to meet all the requirements of the code.

“The use of a handheld device to ease vascular access without evaluation of potential access sites, documentation of selected vessel patency, concurrent real-time ultrasound visualization of vascular needle entry, and permanent recording/reporting is NOT reportable using code 76937.”