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Radiology Coding Alert

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Look for 2 Distinct Services in FAST

Published on Thu Jul 03, 2014

Question: Our physician did ultrasounds when trying to evaluate a patient for blunt chest and blunt abdominal trauma in the ER. The ultrasound was mainly done to rule out free intra-abdominal and pericardial fluid. On ultrasound examination, the hepatorenal space, splenorenal space, kidneys (left and right), liver, bladder, and heart were visualized. There was no free fluid seen during the examination. Pericardial effusion was absent and wall motion was present. What CPT® code can we submit for ultrasounds done in ER?

New Jersey Subscriber

Answer: Your physician is attempting to do a FAST Exam or Focused Assessment with Sonography for Trauma exam. The FAST exam is actually 2 distinct diagnostic services looking for free fluid in the abdomen and examining the pericardium. 
 
You would report two codes when the documentation indicates performance of a FAST:
  • For the cardiac fluid examination, you report code 93308 (Echocardiography, transthoracic, real-time with image documentation [2D], includes M-Mode recording, when performed; follow-up or limited study)
  • For the abdominal fluid assessment, you report code 76705 (Ultrasound, abdominal, real time with image documentation, limited [e.g. single organ, quadrant, follow- up]). 

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