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ultrasound soft tissue back, ? code

  1. Red face ultrasound soft tissue back, ? code
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    Hello,
    We are having difficulty coding ultrasound soft tissue of back. We use 76499 the unlisted procedure and are getting denied by insurances and Medicare asking for a more specific code. We cannot use 76800 ultrasound of spinal canal and contents because we are only scanning the soft tissue of back. Medicare's rejection "MA130" doesn't allow to do a written appeal with the documentation. They want a more specific code. Does anyone have a solution to this problem. I appreciate any help. Thanks.

    Susan Carter CPC
    Associates in Radiology of Plattsburgh NY PC
    aropplattsburgh@hotmail.com

  2. #2
    Default
    According to CSI, there are two possible codes for soft tissue of the back. 76604-52 is used for the upper back and 76705 for the lower back.

    Hope this helps!

  3. #3
    Default
    According to CSI, there are two possible codes for soft tissue of the back. 76604-52 is used for the upper back and 76705 for the lower back.

    Hope this helps!

  4. Default
    Do you know if CSI has anything published on this issue, or where I can find the guidelines stating that we should use 76604-52 or 76705?

  5. #5
    Default
    I verified the info in the 2009 CSI Navigator for Diagnostic Radiology.

  6. Default
    Per ACR Ultrasound Coding User's Guide Upper Back 76604-52, lower back 76705.

    Hope this helps. I would follow ACR guidelines since the AMA tends to rely on the ACR for guidance regarding coding.

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