Ultrasound Complete vs Limited Abdomen
In Radiology facility, one CPT code can be used for multiple organs or anatomic site. As we know radiology CPT codes falls under 70000 and 90000 series. We have already learnt about CT, MRI, ultrasound CPT codes here. But, still some of medical coders get confused in coding either MRI or ultrasound CPT codes. For example, if we have to code for gallbladder, liver or urinary bladder ultrasound cpt code, we might get confused with CPT code 76700, 76705 or 76775. The main confusion is between Ultrasound Complete vs Limited Abdomen ultrasound (76700 versus 76705). You will clear this confusion later in this article.
Same happens with MRI cpt codes, we might get confused with non-joint (hand, toe, tibia, ulna, radius, fibula) and joint (elbow, shoulder, knee, hip, ankle) CPT codes. So, let us try to clear our doubts about these topics to avoid doing errors in future.
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Since CPT codes are responsible for payment of procedures, it is really important to be perfect in coding Surgery CPT codes. Mainly the percutaneous procedure like lumbar puncture, arthrogram, lung or thyroid biopsy, vascular catherization procedures are very important to code and learn. Any slight error in coding in such high dollar value procedure can lead to denail or loss in payment.
Many CPT codes nowadays are getting bundled, hence coders can now easily code a single code which will include many small procedure. Below are few Procedure codes which are bundled with guidance or RS&I codes.
Upper extremity Catheritization CPT codes
Epidural Spinal Injection CPT codes
Ultrasound Complete vs Limited Abdomen CPT code for gallbladder/liver
Ultrasound is the first imaging test for gallbladder and bile duct abnormalities. This test is non-invasive, uses no dyes, and is not painful. For coding abdominal ultrasound procedure code, we have two CPT codes 76700 and 76705. For complete ultrasound we should check for all the eight organs gallbladder, liver, common bile duct, two kidneys, aorta, Inferior Vena cava (IVC), pancreas and spleen. Now, if all these organs are present you can go ahead and code CPT code 76700.
And if one of the eight organs is missing you should report with CPT code 76705. Also, abdomen is divided into four quadrants – right upper, right lower, left upper and left lower. Here, also for each particular quadrant you can code limited ultrasound CPT code 76705. So, you have to follow the below coding guideline for coding CPT code 76700 and 76705.
Also for Coding ICD 10 codes, always code the diagnosis depending on the quadrant under examination. For example. if you are coding a procedure code 76705 for right upper quadrant then, you should code a diagnosis related to that quadrant only, not the disorder related to lower quadrant. As you can see the below image, if you code diagnosis for pancreas for RUQ exam, it will considered incorrect coding.
The primary diagnosis should be from the same quadrant which is ordered, the incidental diagnosis can be coded secondary. Some of the common reason for visit and primary diagnosis for gallbladder ultrasound are given below.
Indications: Abdominal pain, fever, nausea, vomiting, flank pain, jaundice
Primary dx or impression: Cholelithiasis (gallstones), Cholecystitis, gallbladder slugde.
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Complete Ultrasound for Abdominal (all eight organs present) 76700
Limited Ultrasound 76705 (for single organ, quadrant or less than eight organs of abdomen)
CPT code for gallbladder ultrasound
CPT code for liver ultrasound
CPT code for spleen ultrasound
CPT code for pancreas ultrasound
CPT code for Inferior vena cava ultrasound
CPT code for aorta ultrasound
Read also: learn when to code Ultrasound guidance CPT code 76942
Renal and urinary bladder Limited ultrasound CPT code 76705
Like ultrasound, we have two CPT codes for complete (76770) and limited ultrasound (76775) for renal exam. But, here two kidneys are common in abdominal and renal exam. Hence, here we should remember, retroperitoneal CPT codes 76770 and 76775 are applied only for two kidneys and urinary bladder. Now, when to report complete and limited renal ultrasound CPT codes
When there is the presence of two kidneys, urinary bladder and renal diagnosis, you can go ahead and report complete retroperitoneal or renal ultrasound CPT code. If any one thing is missing out of these three criteria, you can code the limited renal exam CPT code 76775.
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Supply codes used with CPT code 76700 and 76705
SB036 paper, exam table
SB037 pillow case
SB044 underpad 2ft x 3ft (Chux)
SJ062 ultrasound transmission gel
SM012 disinfectant spray (Transeptic)
SM021 sanitizing cloth-wipe (patient)
SM022 sanitizing cloth-wipe (surface, instruments, equipment)
SB006 drape, non-sterile, sheet 40in x 60in
SB022 gloves, non-sterile
SB026 gown, patient
NCCI edits for CPT code 76700 and 76705
Major Code/Column 1 Minor Code/Column 2 Effective Date Deletion Date Modifier/Policy Indicator 76700 0689T 1/1/2022 * 1-Allowed 76700 36591 10/1/2015 * 0-Not allowed 76700 36592 10/1/2015 * 0-Not allowed 76700 51701 4/1/2003 * 1-Allowed 76700 51702 4/1/2003 * 1-Allowed 76700 76705 1/1/1996 * 1-Allowed 76700 76770 10/1/2022 * 1-Allowed 76700 76775 10/1/2022 * 1-Allowed 76700 76776 1/1/2023 * 1-Allowed 76700 76942 7/1/2016 * 1-Allowed 76700 76970 1/1/2017 12/31/2020 1-Allowed 76700 76981 1/1/2019 * 1-Allowed 76700 76982 1/1/2019 * 1-Allowed 76700 76983 1/1/2019 * 1-Allowed 76700 76986 1/1/2003 12/31/2006 1-Allowed 76700 76998 1/1/2007 * 1-Allowed 76700 78730 4/1/2005 12/31/2006 0-Not allowed 76700 96523 4/1/2019 * 0-Not allowed 76700 99201 10/30/2000 10/30/2000 9-Not applicable 76700 99202 10/30/2000 10/30/2000 9-Not applicable 76700 99203 10/30/2000 10/30/2000 9-Not applicable 76700 99204 10/30/2000 10/30/2000 9-Not applicable 76700 99205 10/30/2000 10/30/2000 9-Not applicable 76700 99211 10/30/2000 10/30/2000 9-Not applicable 76700 99212 10/30/2000 10/30/2000 9-Not applicable 76700 99213 10/30/2000 10/30/2000 9-Not applicable 76700 99214 10/30/2000 10/30/2000 9-Not applicable 76700 99215 10/30/2000 10/30/2000 9-Not applicable 76700 99221 10/30/2000 10/30/2000 9-Not applicable 76700 99222 10/30/2000 10/30/2000 9-Not applicable 76700 99223 10/30/2000 10/30/2000 9-Not applicable 76700 99231 10/30/2000 10/30/2000 9-Not applicable 76700 99232 10/30/2000 10/30/2000 9-Not applicable 76700 99233 10/30/2000 10/30/2000 9-Not applicable 76700 99234 10/30/2000 10/30/2000 9-Not applicable 76700 99235 10/30/2000 10/30/2000 9-Not applicable 76700 99236 10/30/2000 10/30/2000 9-Not applicable 76700 99238 10/30/2000 10/30/2000 9-Not applicable 76700 99239 10/30/2000 10/30/2000 9-Not applicable 76700 99241 10/30/2000 10/30/2000 9-Not applicable 76700 99242 10/30/2000 10/30/2000 9-Not applicable 76700 99243 10/30/2000 10/30/2000 9-Not applicable 76700 99244 10/30/2000 10/30/2000 9-Not applicable 76700 99245 10/30/2000 10/30/2000 9-Not applicable 76700 99251 10/30/2000 10/30/2000 9-Not applicable 76700 99252 10/30/2000 10/30/2000 9-Not applicable 76700 99253 10/30/2000 10/30/2000 9-Not applicable 76700 99254 10/30/2000 10/30/2000 9-Not applicable 76700 99255 10/30/2000 10/30/2000 9-Not applicable 76700 99261 10/30/2000 10/30/2000 9-Not applicable 76700 99262 10/30/2000 10/30/2000 9-Not applicable 76700 99263 10/30/2000 10/30/2000 9-Not applicable 76700 99271 10/30/2000 10/30/2000 9-Not applicable 76700 99272 10/30/2000 10/30/2000 9-Not applicable 76700 99273 10/30/2000 10/30/2000 9-Not applicable 76700 99274 10/30/2000 10/30/2000 9-Not applicable 76700 99275 10/30/2000 10/30/2000 9-Not applicable 76700 99291 10/30/2000 10/30/2000 9-Not applicable 76700 99292 10/30/2000 10/30/2000 9-Not applicable 76700 99301 10/30/2000 10/30/2000 9-Not applicable 76700 99302 10/30/2000 10/30/2000 9-Not applicable 76700 99303 10/30/2000 10/30/2000 9-Not applicable 76700 99311 10/30/2000 10/30/2000 9-Not applicable 76700 99312 10/30/2000 10/30/2000 9-Not applicable 76700 99313 10/30/2000 10/30/2000 9-Not applicable 76700 99321 10/30/2000 10/30/2000 9-Not applicable 76700 99322 10/30/2000 10/30/2000 9-Not applicable 76700 99323 10/30/2000 10/30/2000 9-Not applicable 76700 99331 10/30/2000 10/30/2000 9-Not applicable 76700 99332 10/30/2000 10/30/2000 9-Not applicable 76700 99333 10/30/2000 10/30/2000 9-Not applicable 76700 99341 10/30/2000 10/30/2000 9-Not applicable 76700 99342 10/30/2000 10/30/2000 9-Not applicable 76700 99343 10/30/2000 10/30/2000 9-Not applicable 76700 99344 10/30/2000 10/30/2000 9-Not applicable 76700 99345 10/30/2000 10/30/2000 9-Not applicable 76700 99347 10/30/2000 10/30/2000 9-Not applicable 76700 99348 10/30/2000 10/30/2000 9-Not applicable 76700 99349 10/30/2000 10/30/2000 9-Not applicable 76700 99350 10/30/2000 10/30/2000 9-Not applicable 76700 99354 10/30/2000 10/30/2000 9-Not applicable 76700 99355 10/30/2000 10/30/2000 9-Not applicable 76700 99356 10/30/2000 10/30/2000 9-Not applicable 76700 99357 10/30/2000 10/30/2000 9-Not applicable 76700 G0471 7/1/2015 * 1-Allowed 76705 0689T 1/1/2022 * 1-Allowed 76705 36591 10/1/2015 * 0-Not allowed 76705 36592 10/1/2015 * 0-Not allowed 76705 51701 4/1/2003 * 1-Allowed 76705 51702 4/1/2003 * 1-Allowed 76705 76770 10/1/2022 * 1-Allowed 76705 76775 10/1/2022 * 1-Allowed 76705 76776 1/1/2023 * 1-Allowed 76705 76942 7/1/2016 * 1-Allowed 76705 76970 1/1/2017 12/31/2020 1-Allowed 76705 76983 1/1/2019 * 1-Allowed 76705 76986 1/1/2003 12/31/2006 1-Allowed 76705 76998 1/1/2007 * 1-Allowed 76705 78730 4/1/2005 12/31/2006 0-Not allowed 76705 96523 4/1/2019 * 0-Not allowed 76705 99201 10/30/2000 10/30/2000 9-Not applicable 76705 99202 10/30/2000 10/30/2000 9-Not applicable 76705 99203 10/30/2000 10/30/2000 9-Not applicable 76705 99204 10/30/2000 10/30/2000 9-Not applicable 76705 99205 10/30/2000 10/30/2000 9-Not applicable 76705 99211 10/30/2000 10/30/2000 9-Not applicable 76705 99212 10/30/2000 10/30/2000 9-Not applicable 76705 99213 10/30/2000 10/30/2000 9-Not applicable 76705 99214 10/30/2000 10/30/2000 9-Not applicable 76705 99215 10/30/2000 10/30/2000 9-Not applicable 76705 99221 10/30/2000 10/30/2000 9-Not applicable 76705 99222 10/30/2000 10/30/2000 9-Not applicable 76705 99223 10/30/2000 10/30/2000 9-Not applicable 76705 99231 10/30/2000 10/30/2000 9-Not applicable 76705 99232 10/30/2000 10/30/2000 9-Not applicable 76705 99233 10/30/2000 10/30/2000 9-Not applicable 76705 99234 10/30/2000 10/30/2000 9-Not applicable 76705 99235 10/30/2000 10/30/2000 9-Not applicable 76705 99236 10/30/2000 10/30/2000 9-Not applicable 76705 99238 10/30/2000 10/30/2000 9-Not applicable 76705 99239 10/30/2000 10/30/2000 9-Not applicable 76705 99241 10/30/2000 10/30/2000 9-Not applicable 76705 99242 10/30/2000 10/30/2000 9-Not applicable 76705 99243 10/30/2000 10/30/2000 9-Not applicable 76705 99244 10/30/2000 10/30/2000 9-Not applicable 76705 99245 10/30/2000 10/30/2000 9-Not applicable 76705 99251 10/30/2000 10/30/2000 9-Not applicable 76705 99252 10/30/2000 10/30/2000 9-Not applicable 76705 99253 10/30/2000 10/30/2000 9-Not applicable 76705 99254 10/30/2000 10/30/2000 9-Not applicable 76705 99255 10/30/2000 10/30/2000 9-Not applicable 76705 99261 10/30/2000 10/30/2000 9-Not applicable 76705 99262 10/30/2000 10/30/2000 9-Not applicable 76705 99263 10/30/2000 10/30/2000 9-Not applicable 76705 99271 10/30/2000 10/30/2000 9-Not applicable 76705 99272 10/30/2000 10/30/2000 9-Not applicable 76705 99273 10/30/2000 10/30/2000 9-Not applicable 76705 99274 10/30/2000 10/30/2000 9-Not applicable 76705 99275 10/30/2000 10/30/2000 9-Not applicable 76705 99291 10/30/2000 10/30/2000 9-Not applicable 76705 99292 10/30/2000 10/30/2000 9-Not applicable 76705 99301 10/30/2000 10/30/2000 9-Not applicable 76705 99302 10/30/2000 10/30/2000 9-Not applicable 76705 99303 10/30/2000 10/30/2000 9-Not applicable 76705 99311 10/30/2000 10/30/2000 9-Not applicable 76705 99312 10/30/2000 10/30/2000 9-Not applicable 76705 99313 10/30/2000 10/30/2000 9-Not applicable 76705 99321 10/30/2000 10/30/2000 9-Not applicable 76705 99322 10/30/2000 10/30/2000 9-Not applicable 76705 99323 10/30/2000 10/30/2000 9-Not applicable 76705 99331 10/30/2000 10/30/2000 9-Not applicable 76705 99332 10/30/2000 10/30/2000 9-Not applicable 76705 99333 10/30/2000 10/30/2000 9-Not applicable 76705 99341 10/30/2000 10/30/2000 9-Not applicable 76705 99342 10/30/2000 10/30/2000 9-Not applicable 76705 99343 10/30/2000 10/30/2000 9-Not applicable 76705 99344 10/30/2000 10/30/2000 9-Not applicable 76705 99345 10/30/2000 10/30/2000 9-Not applicable 76705 99347 10/30/2000 10/30/2000 9-Not applicable 76705 99348 10/30/2000 10/30/2000 9-Not applicable 76705 99349 10/30/2000 10/30/2000 9-Not applicable 76705 99350 10/30/2000 10/30/2000 9-Not applicable 76705 99354 10/30/2000 10/30/2000 9-Not applicable 76705 99355 10/30/2000 10/30/2000 9-Not applicable 76705 99356 10/30/2000 10/30/2000 9-Not applicable 76705 99357 10/30/2000 10/30/2000 9-Not applicable 76705 G0471 7/1/2015 * 1-Allowed
Medical coding example for Gallbladder Ultrasound (76705 CPT code)
US/US GALLBLADDER-BILIARY (RUQ)
CLINICAL DATA: Elevated liver enzymes
EXAM: US ABDOMEN LIMITED – RIGHT UPPER QUADRANT
FINDINGS:
Gallbladder: Within the gallbladder, there is a 5 x 3 mm echogenic focus along the wall which neither moves nor shadows. A second 4 x 3 mm echogenic focus which neither moves nor shadows is seen. A third focus measuring 5 x 3 mm is also seen which neither moves nor shadows. There are no echogenic foci which move and shadow as is expected with gallstones. No gallbladder wall thickening or pericholecystic fluid. No sonographic Murphy sign noted.
Common bile duct: Diameter: 5 mm. There is no intrahepatic or extrahepatic biliary duct dilatation.
Liver: No focal lesion identified. Liver echogenicity is overall mildly increased.
IMPRESSION: There are 3 echogenic foci in the gallbladder, largest measuring 5 These foci are felt to represent polyps. Given this finding, a followup study in approximately 1 year to assess for stability would be advisable. No echogenic foci which move and shadow as is expected with gallstones seen. No gallbladder wall thickening or pericholecystic fluid.
Increased liver echogenicity is most likely indicative of a degree of hepatic steatosis. While no focal liver lesions are identified, it must be cautioned that the sensitivity of ultrasound for focal liver lesions is diminished in this circumstance.
CPT – 76705 (only 3 organs)
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Medical coding example for Renal Ultrasound CPT code
US/US RENAL
CLINICAL DATA: Hydronephrosis noted on prenatal scan ; patient is now 10-day-old and here for follow-up exam
EXAM: RENAL / URINARY TRACT ULTRASOUND COMPLETE
COMPARISON: None in PACs
FINDINGS: Right Kidney: Length: 4.7 cm.. There is moderate hydronephrosis.
Left Kidney: Length: 5.3 cm. There is moderate hydronephrosis. Bladder: The urinary bladder contains echogenic mobile layering debris.
Bilateral ureteral jets are observed.
IMPRESSION: There is moderate bilateral hydronephrosis. Bilateral ureteral jets are visualized. There is echogenic mobile debris within the urinary bladder.
CPT – 76770 (two kidneys, bladder and renal diagnosis)
Hope, this coding guide will clear all confusion in coding Ultrasound Complete vs Limited (76700 vs 76705) Coding abdomen and renal ultrasound CPT codes. Please do share this article if you liked it.