Member is a 60 year old male with no previous history of smoking but with abdominal symptoms requiring an abdominal ultrasound. This would be considered a preventive service with no cost to the member.Ģ. Provider bills CPT code 76770 with and ICD.10 code Z87.891. Member is a 65 year old male with previous history of smoking and is scheduled for an abdominal aortic aneurysm (AAA) by ultrasonography. Organs located in the retroperitoneal region-Ultrasound may be helpful in evaluation of wounds, contusions, and lacerations of organs located in the retroperitoneal region.Įxamples of Claim Adjudication Scenarios: Preventive vs. Adrenal Gland- Ultrasound is of little value since CT scan is considered more accurate.ĩ. Prostate- Evaluation of the prostate is primarily done transrectally by ultrasound.Ĩ. Ultrasound in this instance should be considered secondary and rarely utilized in the detection or follow up of nodal disease.ħ. Adenopathy- CT is far more accurate than ultrasound in detecting and delineating adenopathy. The presence or absence of signs and symptoms dictate utilization frequency of this modality for renal transplants.Ħ. Renal transplants- Ultrasound is indicated to detect urinary obstruction, fluid collection, and complications of renal transplants and is considered a primary tool in this endeavor. However, ultrasound is useful in following intraluminal bladder tumor with or without extraluminal extension, including evaluation of bladder wall thickness and irregularity.ĥ. Ultrasound has no role in vesicle ureteral reflux.Ĭ) Bladder- Tumors of the bladder are most efficiently followed by cystoscopy and urography. Iii) May be useful as a primary diagnostic tool in patients with hematuria.ī) Ureter- Ureters are usually not well visualized by ultrasound, especially in their mid-portions ultrasound may rarely be helpful to confirm the presence of dilatation, filling defects or a mass, in its most proximal or distal portions. Ii) May be useful in detecting and following renal cysts and localizing solid masses. May also confirm scarred or small kidneys in chronic renal cortical disease (but may be of no use in detecting early or mild cortical disorders or to categorize specific types of cortical diseases).
I) To evaluate obstruction in symptomatic patients and for guidance of percutaneous nephrostomy tubes.
Inferior vena cava- Ultrasound is useful in detection of invasion by adjacent tumors and identification of obstruction levels. Abdominal aorta - Ultrasound is accurate for aortic measurement and may be used to follow patients with aneurysms.ģ. Retroperitoneal ultrasonography may be considered reasonable and necessary for the diagnosis and treatment of the following areas:Ģ. A limited study involves a single quadrant or a single diagnostic problem or an evaluation of an organ of interest. Retroperitoneal ultrasound studies represent the ultrasonic imaging of retroperitoneal organs for the diagnosis and management of abnormalities that occur in the retroperitoneum.Ī complete study visualizes all the structures or organs within the anatomic description of that study. Indications and Limitations of Coverage and/or Medical Necessity 76770 - Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation complete - Average fee amount $100 - $130ħ6775 - Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation limitedħ6776 - Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation
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