Author Topic: Ultrasound Coding  (Read 3075 times)

Meli

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  • Melissa Turner
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Ultrasound Coding
« on: July 16, 2010, 12:55:06 PM »
Hi,

I'm not a coder but asking for advice.  Received a claim to bill for an complete abdominal study ultrasound noting procedure codes 76770, 76705 and 78205.  My question is would this all be covered under 76700 for a complete abdominal ultrasound?  Claim is being billed to Aetna.  Diagnosis code noted is 789.00 for unspecified site but there is a question mark on the daysheet.  I've questioned the question mark and waiting for a response.

Thanks!
Melissa Turner, CPMB
Mainstream Services Inc.
www.msmbinc.com

Alice Scott

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Re: Ultrasound Coding
« Reply #1 on: July 17, 2010, 06:00:45 AM »
I'm not a coder either.  I would bill all codes as given to you and see what Aetna does.  You might want to verify with the provider if any modifiers are to be attached to any of the codes, but get the response in writing.
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oneround

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Re: Ultrasound Coding
« Reply #2 on: July 23, 2010, 02:22:36 PM »
 More than one organ studied may be coded to CPT 76700, "Ultrasound, abdominal complete" although many fiscal intermediaries have differing policies for the use of these codes. You may need to confirm individual state policies. Either CPT 76700


Abdomen and Retroperitoneum Although no new code revisions or additions were developed for the Abdomen and Retro-peritoneum code series (76700-76778), new introductory guidelines have been added. Specifically, the guidelines define a complete abdominal ultrasound and a complete retroperitoneal ultrasound and define the services included (eg, written report) for this code series (76700-76778). The guidelines are as follows: A complete ultrasound examination of the abdomen (76700) consists of B mode scans of: liver, gall bladder, common bile duct, pancreas, spleen, kidneys, and the upper abdominal aorta and inferior vena cava including any demonstrated abdominal abnormality. A complete ultrasound examination of the retroperitoneum (76770) consists of B mode scans of: kidneys, abdominal aorta, common iliac artery origins, and inferior vena cava, including any demonstrated retroperitoneal abnormality. Alternatively, if clinical history suggests urinary tract pathology, complete evaluation of the kidneys and urinary bladder also comprises a complete retroperitoneal ultrasound. Use of ultrasound, without thorough evaluation of organ(s) or anatomic region, image documentation and final, written report, is not separately reportable.

 (76700-76705) based on the anatomic region evaluated and documented in the medical record. According to the Coding Guide for Comprehensive Diagnostic Radiology, CPTs 76700 and 76705 are described as follows: 76700 Ultrasound, abdominal, B-scan and/or real time with image documentation; complete - A complete study is one in which the physician attempts to visualize all the organs within the abdomen. The interpretation should include comments on which organs were actually evaluated. 76705 limted (e.,g., single organ, quadrant, follow-up) - Describes an examination that is limited to either a single organ or a limited area of the abdomen (eg, liver, right upper quadrant, etc). In reviewing the above guidance, a complete study documents the views of all the structures and/or organs within an anatomical area; whereas, a limited study documents views of a single organ, one quadrant, or single diagnostic problem. In your situation, if only a single organ or quadrant was viewed and documented, you might consider reporting the abdomen ultrasound limited view 76705.
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

Meli

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Re: Ultrasound Coding
« Reply #3 on: July 27, 2010, 02:53:01 PM »
Thanks all for the feedback....  ;)
Melissa Turner, CPMB
Mainstream Services Inc.
www.msmbinc.com