ED Coding and Reimbursement Alert

Question: What are FAST exams, and how should I  report one in the ED?


Massachusetts Subscriber
 

Answer: FAST (focused assessment by sonography for trauma) exams are two-part ultrasounds designed to measure abdominal trauma. Since there is no specific code for the procedure, you-ll need a couple of codes to fully report the procedure.

During a FAST exam, the physician first searches for fluid around the heart via a limited transthoracic echocardiography. The second part of the FAST exam involves the physician looking for free fluid in the abdomen via a limited abdominal ultrasound.

On your FAST exam claim, you should:

- report 93308 (Echocardiography, transthoracic, real-time with image documentation [2D] with or without M-mode recording; follow-up or limited study) for the echocardiography part of the test.

- report 76705 (Ultrasound, abdominal, B-scan and/or real-time with image documentation; limited [e.g., single organ, quadrant, follow-up]) for the ultrasound portion of the test.

- attach modifier 26 (Professional component) to 93308 and 76705 to indicate that you are coding the professional component of the FAST exam.

- include actual images from the FAST exam in your documentation, as well as a separately identifiable interpretive report.