Radiology

Radiology Question for the Week of May 4, 2020

Radiology Compliance Question of the Week

Question:

We received a patient from the ER who presented with severe pelvic pain. The HCG indicated pregnancy, but there was no intrauterine pregnancy so an ectopic is suspected. What is the correct CPT® code for this scenario?

Answer:

According to the American Medical Association (AMA) and the American College of Radiology (ACR), the procedure would be reported with an OB ultrasound code because the patient had a positive pregnancy test and symptoms that could be related to a pregnancy. If the maternal uterus and adnexa are documented along with a statement that a gestational sac, yolk sac or fetal pole could not be visualized, then code 76801 is assigned. If the patient presented to the department with the aforementioned pain but without a positive pregnancy test a non-obstetric pelvic code—76856 or 76857—would be assigned.


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