Reader Question:
76604 Is an Unexpected Back Code
Published on Wed Aug 15, 2012
Question:
Which ultrasound code applies for examining a mass on the back? Rhode Island Subscriber
Answer:
The answer depends on whether the physician documents the mass as being on the upper back, the lower back, or focused on the spinal canal.
CPT® Assistant (May 2009) supports the following coding for ultrasound of a palpable soft-tissue mass:
76604,
Ultrasound, chest (includes mediastinum), real time with image documentation Lower back: 76705,
Ultrasound, abdominal, real time with image documentation; limited (e.g., single organ, quadrant, follow-up).
Spinal canal:
Alternatively, if the mass is not suspected of being in soft tissue and the documentation shows ultrasound of the spinal canal, you should report 76800 (
Ultrasound, spinal canal and contents). Remember that "It is inappropriate to report this code for each area of the spine. From a CPT® coding perspective, code 76800 includes the entire spinal canal," according to CPT® Assistant (April 1998).