This "limited" CPT® code captures a focused examination in the assessment of 1 or more elements listed in the "complete" ultrasound above, such as the kidney (s) only. If you do not visualize all the elements outlined in the "complete" description, the limited CPT® code 76705 should be used.
Encounter for routine screening for malformation using ultrasonics
What you can expect
Ultrasonography of Abdomen ICD-10-PCS BW40ZZZ is a specific/billable code that can be used to indicate a procedure.
The Current Procedural Terminology (CPT) code range for Diagnostic Ultrasound Procedures 76506-76999 is a medical code set maintained by the American Medical Association.
ICD-9 Code 789.0 -Abdominal pain- Codify by AAPC.
Under ICD-10-CM Codes that Support Medical Necessity Group 1: Codes added C56. 3 and C79. 63. This revision is due to the Annual ICD-10 Update and will become effective on 10/1/2021.
CPT CodeCommon Modifier(s)CPT Description76705-26Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)
CPT code 76856 represents a non-obstetrical transabdominal ultrasound, real time with image documentation; complete.
84.
9: Fever, unspecified.
ICD-10 code R10. 9 for Unspecified abdominal pain is a medical classification as listed by WHO under the range - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified .
ICD-10-PCS Code BW25YZZ - Computerized Tomography (CT Scan) of Chest, Abdomen and Pelvis using Other Contrast - Codify by AAPC.
RE: basic anatomy 76805 Z36. 3 (Encounter for antenatal screening for malformations) is the appropriate ICD-10 to use with 76805.
The provider can bill for both ultrasounds and radiology can bill for the comprehensive transvaginal ultrasound 76817-77 (CPT modifier -77 for repeat examination by second physician with a different group Medicare provider number) [13].
Prep: NPO 6 hours including no smoking and no gum, however, may take medications with small amounts of water If gallbladder evaluation is not needed, all fluids are ok.
If known nodule meets criteria for FNA, and repeat imaging of thyroid is required.
Prep: None / preferred that exam date is performed on days 13-19 of patient’s menstrual cycle if possible.
Abdominal ultrasound examinations (Procedure codes 76700- 76775) and abdominal duplex examinations (Procedure codes 93975, 93976) are generally performed for different clinical scenarios although there are some instances where both types of procedures are medically reasonable and necessary. In the latter case, the abdominal ultrasound procedure Procedure code should be reported with an NCCI-associated modifier.
(HMO, Aetna Health Network Only plans and Aetna Health Network Option plans) Obstetric care providers who participate in the limited obstetric ultrasound enhancement program perform all necessary limited (first, second or third trimester) ultrasounds in their offices and receive an enhancement to their global obstetric fee, regardless of the number of limited ultrasounds performed. These ultrasound CPT codes include:
In this scenario, it would be appropriate to code 76856 for the pelvic ultrasound and 93976-59 for the limited vascular study of the ovary.
In order to code an abdominal duplex study, true vascular analysis needs to be performed. Abdominal duplex should not be coded when color is just turned on to determine if a structure is vascular (e.g., distinguishing hepatic artery from the common bile duct).
Yes, if an ultrasound of the liver is performed, and there is a clinical need for further evaluation by duplex scanning, then it is appropriate to code for both 76705 and 93975.
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
Title XVIII of the Social Security Act, §1833 (e) states that no payment shall be made to any provider for any claim which lacks the necessary information to process the claim.
The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Nonobstetric Pelvic Ultrasound L37636.
Any ICD-10-CM code that is not listed in the ICD-10-CM Codes that Support Medical Necessity section of this Billing and Coding: Nonobstetric Pelvic Ultrasound A56671 article.
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.