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Testicular Sonogram question

  1. #1
    Question Testicular Sonogram question
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    Testicular sonogram: We charge for Doppler for all cases. Does the script need to say Doppler,flow or torsion, in order to bill the Doppler portion? Or is it just assumed that the Doppler is part of the normal protocol for imaging testicles? If so, why would there ever be a charge for testicular without Doppler?

    Thanks ,


  2. Default
    Hi, please see the Question/Answer info and link below from SuperCoder regarding medical necessity and documentation:

    User id : 19756Posted 2 years ago #

    "The two codes are not bundled but I am wondering if it is correct to do a duplex study with every US scrotum study. I remember reading somewhere that you should have a justifiable reason to do the duplex study and that it shouldn't be "protocol" to do both on every study. Is there any documentation to back this up?

    SuperCoderPosted 2 years ago #

    CPT 76870, a diagnostic ultrasound,is ordered when the medical necessity is to report internal anatomy of scrotum and scrotal contents. The medical necessity like encysted hydrocele, azoospermia, oligospermia, orchitis and epididymitis reflect the need to order 76870.
    CPT 93976(duplex) is to monitor arterial blood inflow and venous outflow, so the medical necessity is entirely different focusing on vascular abnormality like aneurysm, thrombosis, vascular insufficiency, injury of blood vessels going towards and away from scrotal regions.
    Preconditions to perform both:
    -Both are ordered by the referring physician due to medical necessity, and both studies are performed and documented (check for CCI edits on these code combinations).
    -Duplex study represented by codes 93975/93976 should not be coded just for a quick look with color Doppler is done to check whether flow is present or for structure identification.
    -Documentation of the assessment of flow with color, recording a spectral waveform, and a report of the findings are MUST to assign codes 93975/93976."

    I hope this information is helpful.

    Jean Kayser CPC CIRCC

  3. #3
    Default Testicular sonogram question
    Thanks for the information

    The question I need to know most is, does the testicular sono script NEED to say Doppler, flow, torision in order to bill for the color doppler?

    Thanks for the help. It is really appreciated
    Last edited by; 04-16-2014 at 06:43 AM. Reason: need more info

  4. Default
    Hi, here is another question/answer link pertaining to your question regarding what is actually ordered versus what is actually performed and billed. The author works in Radiology Compliance. If this doesn't help, maybe someone else more familiar with the compliance side regarding the orders can answer your question.


    Thanks, Kristen.

    Jean Kayser CPC CIRCC

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