For codes 37182 (insertion of transvenous intrahepatic portosystemic shunt(s) [TIPS]) and 37183 (revision of TIPS), the Summer 2010 issue of the Clinical Examples in Radiology (p 2) provides the following instructions: The ultrasound guidance for vascular access performed for the evaluation of a potential access site is separately reported as the ultrasound guidance was not valued into the TIPS insertion or revision codes ( 37182 and 37183 ) when these codes were developed. Add-on code 76937 , 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 (List separately in addition to code for primary procedure), requires that a permanent recorded image(s) of the vascular access site is included in the patient record, as well as a documented description of the process within the procedure report. Therefore, it would not be appropriate to report code 76937 for instances when ultrasound is used only to identify a vessel or mark a skin entry point. Code 76937 was created as an add-on code to report ultrasound guidance for vascular access that is provided in conjunction with another procedure for which ultrasound is not inherent. This code was intended to be reported by the physician who is performing the interventional procedure and providing ultrasound imaging services for vascular access. If ultrasound guidance for vascular access meets the criteria for vascular access, does this fall under "all associated imaging guidance," or is it appropriate to report code 76937 per the instructions from the Clinical Examples in Radiology because it was not included in the value when the code was created? ...
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Article Overview
This article reviews radiology coding guidance for TIPS-related procedures and associated ultrasound guidance reporting. It explains the documentation and reporting context discussed in Clinical Examples in Radiology and notes how the relevant CPT code set materials address the relationship between the primary procedure codes and the ultrasound guidance add-on code. The content is intended for coders, radiology billing staff, and clinicians who document interventional procedures.
Why This Topic Matters
Understanding how the procedure and imaging guidance codes are discussed together helps readers determine whether the article is relevant to their radiology coding workflow and documentation review.
Article Sections
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Clinical Examples in Radiology guidance
Discusses the radiology coding context, documentation expectations, and the relationship between the procedure codes and associated ultrasound guidance reporting.
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CPT 2023 note reference
Summarizes the later code set reference mentioned in the article and its relevance to the procedure and imaging guidance discussion.
What You Will Learn
- The radiology coding context for TIPS-related procedures
- How the article frames ultrasound guidance documentation and reporting
- Which code set references are mentioned in relation to the guidance
- What source materials are cited for additional context
Who Should Read This
- Medical coders
- Radiology billing staff
- Interventional radiology documentation specialists
- Physicians documenting interventional procedures
Codes Discussed
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