Cardiology Coding Alert
Overlapping Anatomy Can Cause 76700/76770 Problems
Question: Our referring physician requests abdominal and renal ultrasound together. Can we bill abdominal (76700) and renal ultrasound (76770) on the same claim? Please advise as we have been getting denials.
New Mexico Subscriber
Answer: There are no Correct Coding Initiative (CCI) edits that apply to the pairing of 76700 (Ultrasound, abdominal, real time with image documentation; complete) and 76770 (Ultrasound, retroperitoneal [e.g., renal, aorta, nodes], real time with image documentation; complete). Some payers however, may deny payment. This is because there is a substantial overlap in these codes. Specific diagnosis codes may help the payer understand the reasoning for performing both exams.
Anatomy covered in the codes: A complete ultrasound examination of the retroperitoneum (76770) consists of real time scans of the kidneys, abdominal aorta, common iliac artery origins, and inferior vena cava, including any demonstrated retroperitoneal abnormality. Alternatively, if clinical history suggests a urinary tract pathology, complete evaluation of the kidneys and urinary bladder also comprises a complete retroperitoneal ultrasound, according to CPT® guidelines. Code 76700 includes real-time 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. The last three overlap to some degree with 76770.
Check with your payer: Your payer may allow you to report these codes together. If not, you may try to report a complete code for one area and a limited code for the other to avoid claiming twice for evaluation of the same anatomy.
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Overlapping Anatomy Can Cause 76700/76770 Problems
Question: Our referring physician requests abdominal and renal ultrasound together. Can we bill abdominal (76700) [...]
