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Billing, collection and practice management for anesthesia and pain management groups.


Is Ultrasound Guidance Billable for Arterial Line Placement?

Published on April 30, 2021

CPT code 76937 is defined as “ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent real time ultrasound visualization of vascular needle entry, with permanent recording and reporting”.  You are not to report CPT code 76937 along with 33274, 33275, 36568, 36569, 36572, 36573, 36584, 37191, 37192, 37193, 37760, 37761, and 76942.  However, CPT code 36620 is not listed as one of the codes you should not report in conjunction with 76937, which leads to the question, is it allowable to bill 76937 with 36620 (A-Lines) if all required documentation is found in the medical record?

Confusion as to whether to bill for ultrasound guidance begin in 2012 when CGS Medicare published an article stating that through clarification with AMA/CPT, code 76937 – Ultrasound guidance for vascular access, would only apply to venous procedures and gave know additional information as to which codes would or would not apply to be billed in conjunction. In 2019 was amended to state that 76937 could not be billed with a full listing of procedures as stated above yet 36620 (A-Lines) was not listed suggesting that 76937 could be billed for A-Line placement.

Current request to the AMA for clarification on the issue suggest that they have changed their opinion on the matter and feel it is acceptable to bill ultrasound guidance along with arterial line placement.  Proper billing of CPT code 76937 requires the following documentation:

  1. Ultrasound evaluation of possible access sites.
  2. Patency of the selected vessel.
  3. Realtime visualization of the vascular needle entry.
  4. Permanent recording of images and reporting.

Given this new opinion from the AMA and if all the guidelines are followed and clearly documented, your practice can determine if billing CPT 76937 along with 36620 is appropriate.  Always keep in mind if a particular payer has policies that do not allow billing both procedures, that payers policy will overrule the opinion of the AMA.    

Kelli Smith

Special Projects Manager