Ultrasound Question for the Week of January 9, 2017

Question:

Question:

When billing for a prostate ultrasound that is not transrectal, would it be more appropriate to use 76775 (limited retroperitoneal) or 76857 (limited non-OB pelvis)?

Answer:

Answer:

You would assign code 76857 if only the prostate is examined, or assign 76856 if a complete pelvic exam is performed to include the prostate. The CPT book tells us that 76856 is appropriate for a complete exam of the male pelvis including evaluation and measurements of the bladder, evaluation of the prostate and seminal vesicles and any pelvic pathology. Therefore, if only the prostate is evaluated transabdominally, then 76857 would be the appropriate code.