Radiology Coding Alert

On the other hand, B-scan ultrasounds, also known as brightness scans, deliver cross-sectional, two-dimensional views of the patient’s eyes. B-scan ultrasounds aid in diagnosing vitreous bleeding, tumors, retinal detachment, or foreign body presence.

Documentation clues: Physicians will use several different terms in the documentation to support A and B scans.

• A-scan: Spike height, reflectivity, regularity, and sound attenuation.
• B-scan: Lesion visualization, borders, lesion size, and shape.

Under the head and neck subsection of the diagnostic ultrasound codes, you’ll find the following ophthalmic ultrasound codes:

• 76510 (Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter)
• 76511 (… quantitative A-scan only)
• 76512 (… B-scan (with or without superimposed non-quantitative A-scan))
• 76513 (… anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral)
• 76514 (… corneal pachymetry, unilateral or bilateral (determination of corneal thickness))
• 76516 (Ophthalmic biometry by ultrasound echography, A-scan)
• 76519 (… with intraocular lens power calculation)

Laterality tip: CPT^® codes 76510-76513 are considered unilateral, so when these scans are performed on both eyes, you must use modifiers LT (Left side), RT (Right side), 50 (Bilateral procedure), or a unit value of “2.” But 76516 and 76519 are inherently bilateral and shouldn’t have modifier 50 appended to them. Neither should 76514, as its descriptor specifies “unilateral or bilateral.”