Radiology Coding Alert

Question: Is there a separate billing code for color Doppler added to an abdominal ultrasound when it is not a vascular study?


New York Subscriber

Answer: If you performed complete abdominal vessel studies, you should report 93975 (Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents, and/or retroperitoneal organs; complete study) for the Doppler and 76700 (Ultrasound, abdominal, B-scan, and/or real time with image documentation; complete) for the ultrasound.

How do you know if your abdominal ultrasound was "complete"? CPT guidelines state that "a complete ultrasound examination of the abdomen (76700) consists of B mode scans of the liver, gall bladder, common bile duct, pancreas, spleen, kidneys, and the upper abdominal aorta and inferior vena cava including any demonstrated abdominal abnormality."

According to the ACR's Ultrasound Coding User's Guide, a complete duplex scan refers to evaluation of both arterial inflow and venous outflow for the same organ. The physician does not need to evaluate all of the intra-abdominal vasculature in order to charge for a complete duplex (93975).

If you performed a limited abdominal study (for example, of the liver only), you should report 76705 (Ultrasound, abdominal, B-scan and/or real time with image documentation; limited [e.g., single organ, quadrant, follow-up]) for the ultrasound.

If you evaluated only the hepatic arteries OR the hepatic veins, report 93976 (Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents, and/or retroperitoneal organs; limited study).

The interpretation and report for the services you performed should clearly document the extent of each abdominal ultrasound procedure.