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Ultrasound coding

Dawnde Posted Wed 31st of May, 2017 17:04:03 PM
1. My billing department is telling me that I need two diagnosis codes for an Ultrasound study that also has a vascular study ex: Scrotal with Doppler(76870/93976) or renal with Doppler (76775/93976. we are using the 59 modifier. 2. When a bladder pre and post void is ordered which code should we use?
SuperCoder Answered Thu 01st of June, 2017 08:06:34 AM

HI,

  • CPT 76870, a diagnostic ultrasound,is ordered when the medical necessity is to report internal anatomy of scrotum and scrotal contents. The medical necessity like encysted hydrocele, azoospermia, oligospermia, orchitis and epididymitis reflect the need to order 76870.

 

  • CPT 93976(duplex) is to monitor arterial blood inflow and venous outflow, so the medical necessity is entirely different focusing on vascular abnormality like aneurysm, thrombosis, vascular insufficiency, injury of blood vessels going towards and away from scrotal regions.
  • Preconditions to perform both:-Both are ordered by the referring physician due to medical necessity, and both studies are performed and documented so you can bill the diagnosis code as per the reason for encounter and you can bill same diagnosis code for both CPT codes.
  • Post voiding residual bladder volume is not reimbursable by CPT codes 76856 and 76857. Measurement of post voiding residual should be billed using CPT code 51798. 

Hope that helps!

 

Dawnde Posted Thu 01st of June, 2017 13:50:51 PM
Yes. Thank You!
SuperCoder Answered Fri 02nd of June, 2017 00:33:56 AM

Happy to Help!

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