Radiology Coding Alert

Question: Our techs say the liver and spleen are in different quadrants, so we should bill complete abdominal ultrasounds for this service. Is this correct? Connecticut Subscriber Answer: For a liver and spleen ultrasound, you should report a limited exam: 76705 (Ultrasound, abdominal, real time with image documentation; limited [e.g., single organ, quadrant, follow-up]). Although the descriptor includes a single organ or a single quadrant, these are only possible examples. Imaging two organs does not meet the requirements for a complete ultrasound (76700, ... complete), so you should use the limited exam. Here's why: CPT's "Diagnostic Ultrasound" section guidelines specify that for a complete exam, the report should contain a description of the elements CPT states comprise a complete exam for that anatomic area "or the reason that an element could not be visualized (e.g., obscured by bowel gas, surgically absent.)" If you don't meet these requirements, the guidelines instruct [...]