Urology Coding Alert

Question: Our office is able to perform ultrasound with Doppler, but we do not have a color printer for our ultrasound machine. Therefore, when a patient comes in with scrotal pain and swelling, the physician may order a scrotal ultrasound with Doppler. When we perform the scrotal ultrasound with Doppler, the technician first performs a regular scrotal ultrasound and prints the film. Then, the physician goes into the room with the technician so he can personally see the monitor and record the findings of the Doppler study. Which codes should we be using to properly report this procedure to our carriers?


Pennsylvania Subscriber

Answer: The first code you should report is 93976 (Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study). Because your urologist is scanning only the scrotal contents, you should report the limited study using 93976. If your urologist performed a complete study of all the listed organs described in the code description, you could report 93975 (Duplex scan of  arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study). In addition, use 76870 (Ultrasound, scrotum and contents) to report the scrotal sonogram that your physician performs.

Caution: If the carrier asks for images, they certainly would want to see both the scrotal sonogram and the color Doppler images. If you can't generate color images, this doesn't necessarily mean you shouldn't report the work your urologist did or that you should not be paid. Even though you lack the ability to get an image of the blood flow to the scrotal contents, you should report and bill for both procedures.

Be sure, however, that your urologist's documentation is detailed and complete. He should clearly document what he saw during the Doppler study. The documentation should also acknowledge that while your urologist doesn't have the technology to produce an image of the blood flow, he does have an image of the scrotal contents and was able to see and view the blood vessels during the Doppler study. If the carrier requests a copy of the images that you cannot produce, complete and thorough documentation could prevent denials.