Radiology Coding Alert

Reader Question:

Renal Ultrasound

Question: Which code should I report for a renal ultrasound -- 76770 or 76775?

North Dakota Subscriber
 
Answer: CPT Code 76770 is defined as echography, retroperitoneal [e.g., renal, aorta, nodes], B-scan and/or real time with image documentation; complete. It would be assigned only if the entire retroperitoneal region or a substantive portion of the region were studied during the ultrasound. On the other hand, 76775 describes a limited study of the same region and is the code most appropriately reported for an ultrasound of only the kidneys. However, it is unlikely that just the kidneys will be studied. Therefore, the choice of code depends on how many organs or how large a section is included in the study. If multiple specific organs within the retroperitoneal region are evaluated, but the "entire" region is not, coders should not use 76775 multiple times, but instead should code 76770 with the -52 modifier (reduced services).

Some payers have determined that a unilateral ultrasound of the kidney is a limited study and that a bilateral evaluation constitutes a complete study, so coders should check with individual payers to confirm their policies.

-- "Reader Questions" and "You Be the Coder" were reviewed by Cindy Parman, CPC, CPC-H, co-owner of Coding Strategies Inc., an Atlanta-based firm that supports 1,000 radiologists and 350 physicians from other specialty areas.