Learn the Definition of a Hyperechoic Pancreatic Mass
Question: I have a radiology report for an ultrasound (US) on a 40-year-old patient. The patient presented to an outpatient radiology practice with complaints of frequent urination and excessive thirst. The radiologist performed an abdominal US and visualized the liver, gallbladder, common bile duct, pancreas, spleen, and kidneys, as well as the upper abdominal aorta and inferior vena cava. The radiologist’s findings mention a “hyperechoic mass in the pancreas, suggestive of a pancreatic tumor.” What is a hyperechoic mass, and what codes should I report for the encounter? Indiana Subscriber Answer: A hyperechoic mass is an abnormality that appears brighter compared to the surrounding tissue on a US scan. The radiologist noted the abnormality during the imaging exam and that it could be a malignancy, but another physician would need to perform further testing to confirm the pathology. For this encounter, assign 76700 (Ultrasound, abdominal, real time with image documentation; complete) to report the complete abdominal US procedure. The CPT® guidelines instruct that a complete abdominal US needs to include visualization of the liver, gallbladder, common bile duct, pancreas, spleen, and kidneys — as well as the upper abdominal aorta and inferior vena cava. If the radiologist imaged only one or some of the structures mentioned, but not all of them, then you’d use 76705 (… limited (eg, single organ, quadrant, follow-up)) to report a limited abdominal US. Next, you’ll look at the ICD-10-CM code book to report the hyperechoic mass of the pancreas. Assign K86.9 (Disease of pancreas, unspecified) for the radiologist’s findings. This code is designated for an abnormality in the pancreas that doesn’t have further specification in the documentation. In your case, additional testing is needed to confirm the pathology of the mass, so K86.9 will suffice until a definitive diagnosis is made. Mike Shaughnessy, BA, CPC, Development Editor, AAPC
