Summary & Overview
CPT 76932: Ultrasound Guidance Imaging for Endomyocardial Biopsy
CPT code 76932 designates the imaging supervision and interpretation associated with ultrasound guidance for an endomyocardial biopsy — a targeted cardiac procedure to obtain myocardial tissue. Nationally, accurate reporting of this code distinguishes imaging interpretation from the separately reportable biopsy procedure itself, affecting billing clarity, clinical documentation, and payer adjudication for cardiac interventional services.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain a concise overview of the clinical context for use of the code, typical sites of service where the procedure occurs, and the common payer landscape for coverage and adjudication. The publication outlines billing considerations relevant to documentation and reporting, summarizes typical modifier usage patterns where available, and situates 76932 within related cardiac procedural coding practices.
This summary is intended for a national audience of coding professionals, clinicians involved in cardiac procedures, and revenue cycle stakeholders seeking to understand when to report imaging supervision and interpretation separate from the endomyocardial biopsy procedure and what to review in payer policies and internal documentation workflows.
Billing Code Overview
CPT code 76932 describes imaging supervision and interpretation for ultrasound guidance during a separately reportable endomyocardial biopsy, a procedure that obtains tissue samples from the heart muscle. The service is an imaging support activity provided contemporaneously with a separately reported biopsy procedure and does not itself include the biopsy performance.
Service type: Imaging supervision and interpretation for procedure guidance
Typical site of service: Hospital inpatient or outpatient setting, cardiac catheterization laboratory, or specialized procedural suite where endomyocardial biopsies are performed
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with unexplained cardiomyopathy and persistent ventricular arrhythmias is referred for endomyocardial biopsy after noninvasive testing (echocardiography, cardiac MRI) suggests inflammatory or infiltrative myocardial disease. The procedure is scheduled in a hospital cardiac catheterization laboratory or an interventional cardiology suite. Under conscious sedation or general anesthesia, the interventional cardiologist obtains right (or left, if indicated) endomyocardial biopsy samples via a transvenous (or arterial) sheath using bioptome under fluoroscopic and ultrasound guidance. The reporting physician provides real-time ultrasound imaging supervision and interpretation to guide safe bioptome positioning and to evaluate for immediate complications (pericardial effusion, tamponade). Documentation includes indication, informed consent, sedation/anesthesia level, vascular access site, number and location of biopsy specimens, ultrasound findings, any immediate complications and management, and a signed imaging interpretation. Billing captures the separate bioptome tissue sampling service and the imaging supervision/interpretation service reported with 76932 when ultrasound guidance is separately reportable.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician's interpretive service for the ultrasound guidance separate from technical resources |