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Wiki Can both cpt 76885 & 76886 w/ mod 50, 59 be coded for this report?

she803

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US EXTREMITY NON-VASCULAR BIL

History: 0-day-old girl with positive Ortolani and Barlow maneuver on physical examination. Evaluate for hip dysplasia.

Comment: Coronal and transverse images of both hips were obtained utilizing real-time ultrasonography. Both static and dynamic imaging were obtained, with and without stress maneuvers.

Right hip: At rest, there is slightly less than 50% coverage of the femoral head by the bony acetabular roof. With stress maneuvers, mild increased lateral and slight increased posterior subluxation is elicited. There is significant hip laxity, however in part this is due to patient's age. Right acetabular alpha angle measures 55 to 58 degrees, within normal limits. There is no evidence for acetabular dysplasia.

Left hip: At rest, there is complete posterolateral dislocation of the femoral head relative to the acetabulum. Fibrofatty pulvinar tissue is identified. With abduction maneuvers, there is partial relocation of the left femoral head. There is left acetabular dysplasia, with the left acetabular alpha angle measuring 50 to 52 degrees.

Findings discussed with Dr. Madubuko via telephone on 7/22/2011 at 4:41 p.m..

Impression:
Findings consistent with bilateral developmental dysplasia of the hip, with left hip dislocation at rest with associated acetabular dysplasia.
Mild right hip subluxation with stress maneuvers.
 
US EXTREMITY NON-VASCULAR BIL

History: 0-day-old girl with positive Ortolani and Barlow maneuver on physical examination. Evaluate for hip dysplasia.

Comment: Coronal and transverse images of both hips were obtained utilizing real-time ultrasonography. Both static and dynamic imaging were obtained, with and without stress maneuvers.

Right hip: At rest, there is slightly less than 50% coverage of the femoral head by the bony acetabular roof. With stress maneuvers, mild increased lateral and slight increased posterior subluxation is elicited. There is significant hip laxity, however in part this is due to patient's age. Right acetabular alpha angle measures 55 to 58 degrees, within normal limits. There is no evidence for acetabular dysplasia.

Left hip: At rest, there is complete posterolateral dislocation of the femoral head relative to the acetabulum. Fibrofatty pulvinar tissue is identified. With abduction maneuvers, there is partial relocation of the left femoral head. There is left acetabular dysplasia, with the left acetabular alpha angle measuring 50 to 52 degrees.

Findings discussed with Dr. Madubuko via telephone on 7/22/2011 at 4:41 p.m..

Impression:
Findings consistent with bilateral developmental dysplasia of the hip, with left hip dislocation at rest with associated acetabular dysplasia.
Mild right hip subluxation with stress maneuvers.

Code only one of them and not with 50 modifier. If the radiologist (or other physician) performed the manipulation, code 76885. If not, code 76886. The code description is "hips" - making it a bilateral code so you can't use 50 modifier. 76885 includes imaging both at rest and with manipulation.
 
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