2025 CPT code 76998
Effective Date: N/A Radiology Procedures > Diagnostic Ultrasound Procedures Feed
Ultrasonic guidance, intraoperative.
Modifiers such as 26 (Professional Component), 52 (Reduced Services), and TC (Technical Component) may be applicable depending on the circumstances of the service provided. Modifier 59 (Distinct Procedural Service) should be appended if 76998 is performed in conjunction with other procedures not normally reported together, to demonstrate that it represents a separate and distinct service.Always check payer-specific guidelines for modifier usage.
The medical necessity for 76998 must be supported by documentation demonstrating that the use of intraoperative ultrasound guidance was essential for the safe and effective performance of the surgical procedure. The documentation should explain why alternative imaging or surgical techniques were not sufficient and how the use of IOUS improved the accuracy, safety, or outcome of the surgery.
The clinical responsibility for performing and interpreting intraoperative ultrasound (IOUS) typically falls on the surgeon or a qualified radiologist present in the operating room. The provider is responsible for ensuring the proper use of the ultrasound equipment, obtaining high-quality images, and accurately interpreting the findings to guide surgical decision-making.
In simple words: The doctor uses ultrasound during surgery to look at organs and tissues for problems.They put a special probe inside the body to get images and help guide the surgery.This helps them see things like tumors, take samples, or drain fluids.
The provider uses ultrasound guidance during a surgical procedure to examine organs and other tissues for abnormalities. Intraoperative ultrasound (IOUS) scanning and technique vary depending on the application. One technique involves the provider applying an acoustic gel to the end of a specially designed intraoperative transducer, which may or may not be sterilized, and covering the end of the probe with a sterile, snug-fitting cover. The transducer is inserted through a previously made incision and pressed against the organ or tissue being examined. Surface moisture is usually sufficient for probe movement, but sterile saline may be used if needed. The probe is removed after the ultrasound examination, and the surgical procedure continues. IOUS is useful for locating and staging tumors, determining the extent of local metastasis, guiding biopsies, cannulating ducts, and draining abscesses or cysts. It can also document arterial and venous patency during surgery.
Example 1: During a partial hepatectomy, IOUS is used to identify the precise location and margins of a liver tumor, assisting the surgeon in achieving complete resection while preserving healthy tissue., In laparoscopic cholecystectomy, IOUS helps to confirm the anatomy of the biliary tree and identify any variations or abnormalities that may affect the procedure., During a nephrectomy, IOUS is used to assess the vascularity of a kidney tumor and guide the ligation of the renal artery and vein, minimizing bleeding and complications.
Documentation for 76998 should include a detailed operative report describing the use of intraoperative ultrasound guidance, the specific organ or tissue examined, the findings of the ultrasound examination, and how the ultrasound findings influenced surgical decision-making. Permanently recorded images of the ultrasound examination should also be included in the patient's medical record.
- Revenue Code: I3F - ECHOGRAPHY - OTHER
- Modifier TC rule: Modifier TC can be applied when billing for only the technical component of the service.
- Specialties:Surgery, Radiology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center