2025 CPT code 76936
(Active) Effective Date: N/A Revision Date: N/A Radiology - Diagnostic Ultrasound Procedures Radiology Procedures Feed
Ultrasound-guided compression repair of an arterial pseudoaneurysm or arteriovenous fistula.
Modifiers 26 (professional component) and TC (technical component) may be appended depending on the provider and payer rules.
Medical necessity is established by the presence of a symptomatic arterial pseudoaneurysm or arteriovenous fistula causing clinical compromise. The procedure is indicated to prevent complications such as hemorrhage, limb ischemia, or infection.
The physician is responsible for performing the diagnostic ultrasound evaluation, planning the repair, applying the compression technique under real-time ultrasound guidance, and confirming successful repair through post-procedure imaging.
In simple words: The doctor uses ultrasound to find and fix a leak in an artery (pseudoaneurysm) or an abnormal connection between an artery and a vein (arteriovenous fistula).They use special ultrasound to see the blood flow. Then, they carefully apply pressure to close the leak or abnormal connection, checking with ultrasound to make sure it’s fixed.
This procedure involves the use of ultrasound to diagnose and repair an arterial pseudoaneurysm or arteriovenous fistula via compression.Duplex scanning (combining traditional ultrasound with Doppler) is used for diagnosis.Under real-time ultrasound guidance, compression is applied at the neck of the pseudoaneurysm (or arteriovenous fistula) while maintaining blood flow through the supplying artery.Continuous pressure is applied until the lesion is thrombosed and bleeding stops.The procedure may be repeated for multiple fistulas.Post-procedure, duplex ultrasound is used to confirm successful repair.
Example 1: A patient presents with a pulsatile mass in the groin following a recent cardiac catheterization.Duplex ultrasound reveals a pseudoaneurysm.The physician performs ultrasound-guided compression repair, achieving thrombosis of the pseudoaneurysm., A patient with end-stage renal disease develops an arteriovenous fistula in their forearm.The fistula is causing pain and swelling.Under ultrasound guidance, the physician compresses and successfully thromboses the fistula., A trauma patient sustains an arterial injury leading to a pseudoaneurysm.The pseudoaneurysm is successfully treated with ultrasound-guided compression and real-time monitoring.
Detailed pre-procedure and post-procedure ultrasound images, including measurements. Documentation of the compression technique used, duration of compression, and evidence of thrombosis.Physician's interpretation of the ultrasound findings.Clinical notes outlining the diagnosis, procedure performed, and patient's response.
** The use of color Doppler in conjunction with real-time ultrasound for anatomic structure identification is not separately reportable.
- Revenue Code: I4B (IMAGING/PROCEDURE - OTHER)
- Payment Status: Active
- Modifier TC rule: Modifier TC is applicable if only the technical component is billed.
- Specialties:Vascular Surgery, Interventional Radiology
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Ambulatory Surgical Center