Gastroenterology Coding Alert

Reader Question:

Get Specific On Ultrasound Abnormal Findings With 793.6

Question: What ICD-9 code should I bill when physician orders a patient for an ultrasound and he notes down "1.9cm hypoechoic focus in liver"? Virginia SubscriberAnswer: You should go with 793.6 (Nonspecific [abnormal] findings on radiological and other examination of abdominal area, including retroperitoneum). Sometimes, gastroenterologists would review radiographic studies or other studies which, although abnormal, are not diagnostic and do require further studies. ICD-9 793.6 helps explain medical necessity for review of such tests or for the performance of other diagnostic studies (793.5, Nonspecific [abnormal findings] on radiological and other examination of genitourinary organs).You can use 793.6 on your claim when the physician ends up ordering multiple studies on a patient to come up with a definitive diagnosis. Most insurance companies would like to see you use this code to track utilization of high cost radiological studies.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Gastroenterology Coding Alert

View All