Outpatient Facility Coding Alert
Refer to Anatomical Criteria List When Coding 76770, 76775
Question: I am having trouble deciding between 76770 and 76775 on a report I am reading. The findings only make references to the kidneys, besides one single additional line stating “bilateral ureteral jets are seen.” Is this enough to code as 76770? Washington Subscriber Answer: There are two different ways in which the documentation can steer you toward code 76770 (Ultrasound, retroperitoneal [eg, renal, aorta, nodes], real time with image documentation; complete). The first is if the provider documents each of the following anatomical criteria: The CPT® manual also states that “if clinical history suggests urinary tract pathology, complete evaluation of the kidneys and urinary bladder also comprises a complete retroperitoneal ultrasound (US).” In your example, there is no documentation of the bladder, abdominal, aorta, common iliac artery, or inferior vena cava. Therefore, you will have to resort to reporting code 76775 (Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited). Knowledge check: Documentation of the ureters is actually not necessary for either complete or limited retroperitoneal ultrasounds. According to Clinical Examples in Radiology (Summer 2013), normal ureters are typically too small to be properly visualized using ultrasound imaging.
Related Articles
Outpatient Facility Coding Alert
- CPT® Coding:
Note These 3 NCCI Exceptions Involving Extensive Shoulder Debridement
Streamline the billing and reimbursement process by following these rules. Most coders will attest that [...] - Modifiers:
Adhere to these Facility-Specific Guidelines when Billing Bilateral Services
Note underlying differences between ASC, outpatient facility bilateral billing. At first glance, modifier 50 (Bilateral [...] - E/M Coding:
Consider These Factors When Billing Modifier 57 With Minor Surgical Procedures
Don’t let the plethora of conflicting guidelines overwhelm you. Most coders working in physician offices [...] - You Be the Coder:
Refer to Anatomical Criteria List When Coding 76770, 76775
Question: I am having trouble deciding between 76770 and 76775 on a report I am [...] - Reader Question:
Identify Key Differences Between Salivary Duct, Gland Procedures
Question: I’m trying to code a report for a probe dilation of Stenson’s duct due [...] - Reader Question:
Use M43 Code Set to Report Congenital Spinal Fusion
Question: I’ve come across a report that states that the L5-S1 spine has fused together. [...] - Reader Question:
Refer to ICD-10-CM Index, Distinguish Between Unstageable, Unspecified Pressure Ulcers
Question: What’s the difference between an unstageable pressure ulcer and a pressure ulcer with an [...]
