Wiki Us extremity non-vascular vs us breast limited

[claudiak]

Hello Radiology coders! Happy Memorial Day weekend!

I have a slight dilemma. A referring Dr ordered a us breast for an axillary lump but our radiologist dictated it as US extremity non vascular exam (cpt 76880). She states "In the left axilla in region of palpable concern there is a hypoechoic oval, horizontally oriented nodule wihch appears to be intradermal. There is significant increased vascularity associated with the periphery of this nodule.
Impression: vascular intradermal nodule. Clinical followup is recommended. She also stated that ultrasound of the region of interest ONLY was performed.

I usually group the axillary area more with the breast that with extremity. Do
any of you agree. Couldn't she have coded this a 76645 with a modifer 52 for reduced service for the exam of ONLY the region of interest??? Or am I way off base here? What are your thoughts?\

I would appreciate any and all opinions.

Thanks
Claudia K, CPC, Networker

 

[KeriH423]

I agree with you Claudia. A breast us cannot be billed as an extremity study.

Keri H, CIRCC

 

[claudiak]

Breast us vs extremity us

Thanks so much! I am glad you agree. It seems my doctor is out of her comfort zone on some of her exams and is not sure what to code axillary problems with.
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Claudia K, CPC
Networker

 

[Radcoder1313]

I know that this is a gray area for many of us, but according to CSI, the axilla alone should be billed as 76880.