Question How to code liver and kidney ultrasound completed in one visit?

patdow

Contributor
Messages
15
Location
Kingwood, TX
Best answers
0
How do you code for a kidney and liver/abdominal ultrasound that occurred in one visit? Doppler included. Usually I use CPT 93975 and 76700-59 for liver/abdominal ultrasound. And I use 93975 and 76770- 59 for kidney ultrasound. Patient’s dx for kidney US is dorsalgia and elevated liver enzymes for liver US.
 

thomas7331

True Blue
Messages
3,224
Best answers
10
The guidance on this in the NCCI manual is as follows:

Abdominal ultrasound examinations (CPT codes 76700-76775) and abdominal duplex examinations (CPT codes 93975, 93976) are generally performed for different clinical scenarios, although there are some instances where both types of procedures are medically reasonable and necessary . In the latter case, the abdominal ultrasound procedure CPT code should be reported with an NCCI PTP-associated modifier.

So as long as your documentation supports both the duplex studies and ultrasounds as distinct and medically necessary services, then your modifier 59 in these cases would be appropriate.

However, I don't think you can bill two duplex codes 93975 because the complete study includes the vascular imaging for both organs and there is a MUE limit of 1 unit per day for this code.
 
Last edited:

patdow

Contributor
Messages
15
Location
Kingwood, TX
Best answers
0
The guidance on this in the NCCI manual is as follows:

Abdominal ultrasound examinations (CPT codes 76700-76775) and abdominal duplex examinations (CPT codes 93975, 93976) are generally performed for different clinical scenarios, although there are some instances where both types of procedures are medically reasonable and necessary . In the latter case, the abdominal ultrasound procedure CPT code should be reported with an NCCI PTP-associated modifier.

So as long as your documentation supports both the duplex studies and ultrasounds as distinct and medically necessary services, then your modifier 59 in these cases would be appropriate.

However, I don't think you can bill two duplex codes 93975 because the complete study includes the vascular imaging for both organs and there is a MUE limit of 1 unit per day for this code.
Thank you, Thomas, for providing your explanation. From what I understand, I’d code 93975, 76700-59, and 76770-59?
 
Top