Coding Guide for CPT code for abdominal ultrasound with Doppler
CPT code for abdominal ultrasound with doppler is very essential in medical coding. In medical coding, we have separate cpt codes for each anatomic location. Further, we have CPT codes for number of view or complete/limited exams. Here, also we will learn how to code the CPT code for abdominal ultrasound with doppler. The CPT code for abdomen is a direct code for complete and limited exam. The coding for abdomen ultrasound depends on the number of organs studied. It happens we code Doppler exam with ultrasound abdomen. We have separate code for limited and complete exam for Doppler as well. The general signs and symptoms for abdomen ultrasound are abdominal pain , nausea , vomiting, diarrhea etc.
How to reach out to CPT code for abdominal ultrasound
We have two CPT code for abdominal ultrasound, 76700 and 76705. The complete ultrasound of abdomen is codes 76700. The complete ultrasound of abdomen will include eight organs. The eight organs include gallbladder, common bile duct (CBD), liver, pancreas, spleen, inferior vena cava (IVC), aorta and two kidneys. When the exam is complete, we will have documentation of all the eight organs. This complete ultrasound exam of abdomen leads to CPT code 76700. Abdomen is divided into four quadrants. Four quadrants are right upper quadrant (RUQ), left upper quadrant (LUQ), right lower quadrant (RLQ) and left lower quadrant (LLQ). When the exams is limited to only one organ or quadrant of abdomen will lead to limited cpt code 76705. Since, we are limited the exam to only one organ or quadrant we will code ultrasound limited exam code. So, in short we are using following CPT codes for ultrasound abdomen
76700- Complete ultrasound of abdomen
76705- Limited Ultrasound of abdomen
Sometimes, the physician while performing the limited exam, he can perform complete ultrasound exam of abdomen. However, we are not allowed to code for complete exam even if eight organs are not documented. This kind of coding is up coding. If we code complete ultrasound of abdomen, we are billing more.
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CPT code for abdominal ultrasound with Doppler
Doppler is also refer as duplex in medical coding. The Doppler exam is generally performed on the vascular portion of abdomen area. The arterial and venous structure is examined while performing Doppler exam. Hence, while coding the CPT code for abdominal ultrasound with Doppler we have to check for finding of both ultrasound as well as Doppler exam. If both the exam is done, we have to code as per their both RVU value and dollar value. The Doppler exam generally includes the real time ultrasound exam. Therefore, while coding the cpt for Doppler and ultrasound we have CCI edit between them.
CCI edit relation between CPT code for ultrasound abdominal and Doppler exam
When we are coding CPT code for both ultrasound abdomen and Doppler ultrasound, we have CCI edit between them. Since, we know the ultrasound exam includes in the Doppler exam cpt code, we should use modifier to bill both Cpt. We can code both ultrasound and Doppler exam performed only with supported documentation. If the exam says the Doppler exam was performed with ultrasound abdomen without any finding documented for Doppler we cannot code Doppler CPT code. The document should mention about arterial and venous finding with spectral waveform recording. Then only we can go ahead and code Doppler CPT code. The following CPT codes are used for Doppler or duplex exam for abdomen region.
93975– Duplex exam for abdominal arterial inflow and venous outflow, complete
93976 – Duplex exam for abdominal arterial inflow and venous outflow, limited
93980 – Duplex scan of arterial inflow and venous outflow of penile vessels; complete study
93981 – Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study
Now, when are having CCI edit between Doppler codes and ultrasound abdomen CPT Code 76700 and 76705, we use modifier 59 with ultrasound CPT Codes. Modifier 59 is used for distinct procedures. The ultrasound, which is included with Doppler exam, should not be code with Doppler exam. However, we have an ultrasound procedure performed separately with Doppler with supporting documentation we have to code them together. When we bill them together without a 59 modifier, ultrasound abdomen CPT Code will not be paid. The simple reason is that ultrasound abdomen is included with Doppler. However, when we code ultrasound abdomen with 59 modifier along with Doppler exam CPT Code, both the procedures are paid. The simple reason is that modifier 59 with ultrasound abdomen modifies the code as distinct procedure. The distinct procedure helps in the showing the procedure was performed separately and not included with Doppler exam. Hence, both procedures are paid. Therefore, we have to report with both ultrasound abdomen and Doppler exam with supported documentation we will code 93975/93976 with 76700/76705 with 59 modifier.
Hope, now you can code the CPT code for abdominal ultrasound with Doppler exam after reading this article. If you like the article please share it.