CPT code 76942: Ultrasonic guidance for needle placement

What is CPT code 76942?

CPT code 76942 is used to report the use of ultrasonic guidance for needle placement procedures, such as biopsies, joint or bursal injections, fluid aspirations (e.g., pleural or abdominal), and fine needle aspirations (FNA). This service includes real-time imaging, permanent image storage, and formal documentation of the guidance provided by the healthcare provider. The intent is to improve procedural accuracy and safety by directly visualizing the needle’s placement about the targeted anatomical structures.

This code reflects a diagnostic or therapeutic imaging service that adds value to many interventions but is not inherently bundled with all specific codes for needle-based procedures. Therefore, CPT 76942 is reported separately when ultrasound guidance is not included in the base procedure code (for example, many musculoskeletal injection codes allow separate billing, whereas some vascular procedures do not). Following proper payer rules and revenue cycle management guidelines is essential to ensure accurate billing and full reimbursement.

CPT code 79642 documentation requirements

To support 76942 billing guidelines and compliance with payer policies, the following must be clearly documented in the medical record:

• Description of services performed: State that ultrasound guidance was used, specifying the anatomical site and purpose (e.g., “ultrasound-guided needle placement for right shoulder aspiration”).
• Real-time imaging confirmation: Include confirmation that the guidance was performed in real time during the procedure, not pre- or post-operatively.
• Permanent image saved: A saved image should be retained as part of the patient’s medical record, demonstrating the use of ultrasound during the procedure.
• Separate procedure documentation: Indicate that the guidance was distinct from the therapeutic or diagnostic procedure, when applicable.
• Physician's interpretation: Provide a brief note or summary explaining how the imaging contributed to the accuracy of the needle placement.

CPT code 79642 billing guidelines

Correct use of CPT 76942 requires careful attention to coding conventions and modifier application:

Reported separately

Use CPT code 76942 only when the ultrasound guidance is not bundled into the primary procedure code. Check CPT and payer edits to determine if separate billing is allowed.

Use modifier 26 or TC

Use modifier 26 to bill only for the professional component (i.e., interpretation and report) and modifier TC for the technical component (i.e., use of ultrasound equipment and image acquisition). Do note that no modifier is required if billing globally.

Use modifier 59 or 79 when applicable

Apply modifier 59 for a distinct procedural service if ultrasound guidance is performed at a different site or unrelated to the primary procedure. However, modifier 79 is used when the ultrasound-guided procedure is performed during the postoperative period of another procedure and is unrelated.

CPT code 76942 Medicare reimbursement

Medicare requires documentation of medical necessity, permanent image retention, and real-time use. Reimbursement rates may vary based on facility type and geographic location.

Ensure accurate billing

Match the guidance with specific procedural codes and confirm whether a global, professional, or technical charge is appropriate based on the setting and provider role.

Other relevant CPT codes

• 76937: Ultrasound guidance for vascular access with evaluation of patency
• 77002: Fluoroscopic guidance for needle placement
• 77012: CT guidance for needle placement
• 77021: MRI guidance for needle placement