Radiology Coding Alert

Question: What is included in an abdominal ultrasound (U/S), as opposed to a retroperitoneal ultrasound? They are very similar, and I am confused about when to assign each.

Nevada Subscriber  
Answer: This is a very confusing area for most coders because some of the organs viewed during an abdominal ultrasound (76700, echography, abdominal, B-scan and/or real time with image documentation; complete) may also be seen during retroperitoneal study (76770, echography, retroperitoneal [e.g., renal, aorta, nodes], B-scan and/or real time with image documentation; complete).
 
Typically, an abdominal U/S will focus primarily on the upper abdominal region and include the liver, spleen, gallbladder, common duct, pancreas and the hollow upper abdominal viscera. An abdominal U/S might also include images of specific vessels like the inferior vena cava and the upper abdominal aorta, and may also include survey views of the kidneys. Similarly, a retroperitoneal U/S may include images of the aorta and inferior vena cava, but would also produce detailed images of the retroperitoneal structures (kidneys and ureters) and lymph nodes.
 
When reporting these studies, coders should be aware that both are considered complete studies and would be assigned only when images of the entire region are obtained. CPT provides two limited codes (76705, echography, abdominal, B-scan and/or real time with image documentation; limited [e.g., single organ, quadrant, follow-up]; and 76775, echography, retroperitoneal [e.g., renal, aorta, nodes], B-scan and/or real time with image documentation; limited) for anything less than a complete study.