Cardiology Coding Alert

Question: Our physician ordered an abdominal aortic aneurysm ultrasound, 76775, but he was unable to clearly visualize the area. Would you still bill for the test? When he repeats the test, do I use modifier 76?

Alabama Subscriber

Answer: You can report and bill for a diagnostic test that is inconclusive. But if the physician plans to repeat the test, as you note, that suggests he expects to see a different result even without a change in the patient’s status. That could mean that the original test was inconclusive because of provider or technical error. 

If the original test had an error and the physician repeats the test, you should report and bill only the successful test. 

If the patient’s status changes and the physician orders another medically necessary test, then you may report both, appending modifier 76 (Repeat procedure or service by same physician or other qualified health care professional) to the second 76775 (Ultrasound, retroperitoneal [e.g., renal, aorta, nodes), real time with image documentation; limited).