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Stephnaie Posted Wed 11th of December, 2013 18:51:09 PM

If the physician does a complete duplex scan of ANY of the organs (abdominal, pelvic, scrotal contents and /or retroperitoneal) listed on the code can we bill this code?

Stephnaie Posted Thu 12th of December, 2013 13:47:02 PM

Let me clarify my question (because I understand my problem better):)

Regarding the codes 93975/93976... does a "complete" study for the 93975 mean they did a complete study of ANY organ or they did a complete study of ALL organs. On the 93976, does this mean they did a limited study of ANY organs or ALL organ.

Can you tell me where I can find a definition of "complete" scan vs "limited" scan with these codes?

Stephnaie Posted Fri 13th of December, 2013 10:03:26 AM

Will this be answered soon? We have some billing on hold until we get this answer. Thanks.

SuperCoder Answered Mon 16th of December, 2013 09:06:04 AM

If you performed complete abdominal vessel studies, you should report 93975 (Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents, and/or retroperitoneal organs; complete study) for the Doppler and 76700 (Ultrasound, abdominal, B-scan, and/or real time with image documentation; complete) for the ultrasound.

How do you know if your abdominal ultrasound was “complete”? CPT guidelines state that “a complete ultrasound examination of the abdomen (76700) consists of B mode scans of the liver, gall bladder, common bile duct, pancreas, spleen, kidneys, and the upper abdominal aorta and inferior vena cava including any demonstrated abdominal abnormality.”

According to the ACR’s Ultrasound Coding User’s Guide, a complete duplex scan refers to evaluation of both arterial inflow and venous outflow for the same organ. The physician does not need to evaluate all of the intra-abdominal vasculature in order to charge for a complete duplex (93975).

If you performed a limited abdominal study (for example, of the liver only), you should report 76705 (Ultrasound, abdominal, B-scan and/or real time with image documentation; limited [e.g., single organ, quadrant, follow-up]) for the ultrasound.

If you evaluated only the hepatic arteries OR the hepatic veins, report 93976 (Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents, and/or retroperitoneal organs; limited study).

The interpretation and report for the services you performed should clearly document the extent of each abdominal ultrasound procedure.

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