Urology Coding Alert

Question: Can we bill abdominal (76700) and renal ultrasound (76770) together? Please advise as we have been getting denials.

New Mexico Subscriber

Answer: There are no CCI edits that apply for codes 76700 (Ultrasound, abdominal, real time with image documentation; complete) and 76770 (Ultrasound, retroperitoneal [e.g., renal, aorta, nodes], real time with image documentation; complete). Some private payers however, may deny payment for one of these services. This is because there is a substantial overlap in these codes. Specific diagnosis codes may help the payer understand the reasoning for performing both exams.

Anatomy covered in the codes: A complete ultrasound examination of the retroperitoneum (76770) consists of real time scans of the kidneys, abdominal aorta, common iliac artery origins, and inferior vena cava, including any demonstrated retroperitoneal abnormality. Alternatively, if clinical history suggests a urinary tract pathology, complete ultrasonic evaluation of the kidneys and urinary bladder at the same encounter would also comprise a complete retroperitoneal ultrasound (76770). The abdominal study alone (76700) includes real time scans of many organs including the liver, gall bladder, common bile duct, pancreas, spleen, kidneys, and the upper abdominal aorta and inferior vena cava including any demonstrated abdominal abnormality.

Check with your payer: Your payer may allow you to report these codes together. If not, you may try to report a complete code for one section (76700) and a limited code (76775) for the other to avoid claiming twice for evaluation of the same anatomy.