Modifier Coding Alert
Remember TC to Make Your FAST Exam Claims Go
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Question: A 40-year-old man was brought to the emergency department (ED) by ambulance after a car crash; the patient hit a tree while driving about 40 mph. He complained of worsening left upper quadrant abdominal pain. He also had hypotension in the field that the emergency medical technician (EMT) resolved on the way to the hospital. Notes indicate that the ED physician performed a focused assessment with sonography for trauma (FAST) exam. How should I code this encounter?
Montana Subscriber
Answer: ED physicians often perform FAST exams for trauma patients, especially if they suspect internal bleeding. A FAST exam consists of two components: a limited transthoracic echocardiography (ECG) to check for pericardial fluid, and a limited abdominal study to check for fluid in the patient’s abdomen.
On your claim, report 93308 (Echocardiography, transthoracic, real-time with image documentation [2D], includes M-mode recording, when performed, follow-up or limited study) for the ECG and 76705 (Ultrasound, abdominal, real time with image documentation; limited [e.g., single organ, quadrant, follow-up]) for the abdominal study. Remember to append modifier 26 (Professional component) to 93308 and 76705 to show that you are only coding for your physician’s services, not the ED equipment.
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