Injections with Ultrasound Guidance

Question:

Is it correct CPT coding to report the ultrasound guidance CPT code 76942 when the physician performs tendon injections or a carpal tunnel injection? The CPT code descriptions for 20550, 20551, and 20526 do not include the terms “with ultrasound guidance, with permanent recording and reporting” in their definitions.

Answer:

There is no AMA CPT coding restriction to reporting CPT code 76942 (Ultrasonic guidance for needle placement [eg, biopsy, aspiration, injection, localization device], imaging supervision and interpretation) when ultrasound guidance is medically necessary for needle localization. These codes do not include image guidance as part of the CPT description like the joint injection CPT codes do (20604, 20606, 20611).

Medical necessity must be present and documented to support this additional work and service.

Refer to payor policies for medical necessity requirements for reporting CPT code 76942 in addition to injections that do not include this work as part of their description.

*This response is based on the best information available as of 12/30/21.