# correct CPT for shear wave elastography



## tag60 (Aug 16, 2016)

Is anyone familiar with this procedure? We've been told to code it using 91200 and 0346T, but I've done a bit of research and I think 91200 may be incorrect. 

The procedure is documented as follows:

Shear Wave Elastography was performed at the bedside using the SuperSonic AIXplorer device. Through a R intercostal approach, liver echogenicity appears normal, mostly isoechoic with renal cortex. Five high-quality images obtained for elastography. Mean elasticity is 7.5 kPa, corroborating a METAVIR fibrosis score of F2.

Here are some sources of information:

http://www.acr.org/Advocacy/Economi...oding/Coding-Source-List/2015/Jan-Feb-2015/QA

http://gi.org/wp-content/uploads/2014/12/395-005PNQ_14-6-CPT_Coding_Updates_FINAL.pdf  (see page 16)

I really could use some feedback on this to make sure I'm not interpreting anything incorrectly, but 91200 seems incorrect for the procedure above. 

Thank you!


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## jag.cpc (Feb 25, 2018)

*91200 vs 0346t,76700 or 76705*

Hi,

    Elastography can evaluate liver stiffness beneficial in determining the amount of fibrosis[/B].We can't be code 91200 along with 0346T.If the report says us liver and elastography and it should be documented to separate document the we can continue to code 76700 or 76705 along with 0346T.I have given below the sample  for your help.

*HEPATIC 2D SHEAR WAVE ELASTOGRAPHY*;INDICATION: Chronic hepatitis C. None;TECHNIQUE: GE LOGIQ E9 SHEAR WAVE ELASTOGRAPHY was utilized for data acquistion. Ten separate measurements of the right hepatic lobe were obtained at end respiration, using an intercostal window at a depth of 1 - 3 cm from the hepatic capsule in fasting patients. All measurements are stored on PACS. The median value is reported.;RESULTS: ;     MEAN: 8.57 kPa;     MEDIAN: 8.54 kPa;     STD: 0.58 kPa;METAVIR SCORE: F 2: Moderate Fibrosis: 8.29 - 9.39 kPa;BIOLOGIC CONFOUNDERS: (Causes of increased liver stiffness in the absence of fibrosis);          1. Hepatic steatosis.;          2. Inflammation (acute hepatitis).;          3. Choletasis.;          4. Right heart failure.;          5. Hepatic venous congestion.;          6. Post-prandial.;          7. Deep inspiration.;


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