76882 CPT code

76882 CPT Code (2022) Description, Guidelines, Reimbursement, Modifiers & Example

76882 CPT code bills for the service when the Physician performs limited ultrasound of non-vascular extremity structure in real-time with image documentation such as peri-articular tendon[s], joint space, muscle[s], nerve[s], other soft tissue structure[s], or soft tissue mass[es]. The Physician performs ultrasound (sound wave) images of one or both arms or legs. Photos may be taken in real-time and superimposed to show movement.

76882 CPT Code Description

The following are reasons why the Physician performs the US of the non-vascular extremity:

Pain in the upper or lower extremity joint

Effusion in the upper or lower extremity joint

Osteoarthritis  in the upper or lower extremity joint

Tendonitis and inflammation of joints

Diagnostic ultrasound is an imaging method that transmits sound waves via the human body through interior body structures. The soundwaves pass through different tissue densities and reflect a receiving unit at varying speeds.

The basic phenomenon of the unit is the conversion of soundwaves into electrical pulses. It represents these pulses simultaneously in the form of an image on the screen. 

Real-time scanning shows the 3D structure of extremities and movent in the joints. It is appropriate to report CPT 76882  when the Physician performs ultrasonography of a complete joint (e.g., joint space, muscles, tendons, and other peri-articular soft tissue structures). 

In contrast, CPT 76882 bills when the Physician performs a limited study of joint or other non-vascular extremities such as joint space, muscle(s), nerve(s), peri-articular tendon(s), soft tissue mass, or different soft tissue structure. It includes the documentation in these services.

cpt 76882

76882 CPT code bills for the service when the Physician performs limited ultrasound of non-vascular extremity structure in real-time with image documentation such as peri-articular tendon[s], joint space, muscle[s], nerve[s], other soft tissue structure[s], or soft tissue mass[es]. 

76882 CPT Code Billing Guidelines

Documentation should support the medical necessity of service. It reflects that service is medically necessary and appropriate.

76882 CPT code bills the Physician performing a limited joint exam, not including the complete joint. It may serve for the evaluation of non-joint structures.

If the Physician performs spectral and color Doppler evaluation, it is appropriate to report with CPT codes 93925, 93926, 93930, 93931, 93970, and 93971 instead of 76882.

If evaluation and management service(99202-9999) performs in addition to CPT code 76882, It is appropriate to report CPT code 76882 separately. 

CPT 76882 Includes limited joint examination or evaluation due to mass or other abnormality not requiring all complete joint evaluation components (76881)

76882 CPT code includes the following elements:

Real-time scans of the specific joint, including assessment:

Includes Joint space

Includes Muscles

Includes Other soft tissue

Includes Tendons

Includes Required permanent image documentation

Includes Written documentation, including an explanation of any joint components not visualized.

76882 CPT Code Modifiers

The following are the list modifiers when 76882 CPT code bills:  

22, 23, 26, 50, 52, 53, 58, 59, 76, 77, 78, 79, 99, AI, AQ, AR, CC, CR, ET, EY, FX, FY, GA, GC, GK, GR, GU, GY, GZ, KX, PT, Q5, Q6, QJ, SG, TC, XR, XP, XU, XS, LT, RT

The most frequent bill modifiers are 26, TC, 77, 76, 59, or X {E, P, S, U} with 76882.    

Modifier 26 bills to indicate the professional component of services when attached with 76882. It shows that the Physician work as an employee in a hospital and facility, not owning the equipment.  

Modifier TC applicable with 76882 indicates the Technical component or machinery used in service. It usually bills with Hospital and facility claims.  

CPT 76882 bills globally when physician-owned the office and equipment. Service bills without TC and 26 modifiers. 

 Modifier 76 is applicable with CPT code 76882 when a similar service performs by the Same Physician on the same day.   

Modifier 77 is applicable with CPT 76882 when a similar service performs by a different Physician on the same service date. 

Modifier 59 is applicable with CPT 76882 when a Distinct service performs by the Physician and bundles with another procedure on the same date.   

Modifier X {E, P, S, U} is applicable instead of Modifier 59 with 76882 CPT code when service bills to medicare insurance. It divides the modifier into four parts for further specification of the procedure. 

If physicians believe that Medicare will deny such service, reporting with a GA  modifier is appropriate. The beneficiary must sign an Advance Beneficiary Notification (ABN), and CPT 76882 must apply the GA modifier to that service. 

Modifier 52 is applicable when the Physician cannot complete the procedure due to unavoidable circumstances.

76882 CPT Code Reimbursement

A maximum of three units can be a bill on the same service date of CPT code 76882. In contrast, the Three unit allows when documentation supports the medical necessity of the service.  

The cost and RUVS of 76882 CPT code with modifier 26 are $25.21 and 0.72841 when performed in the facility. In contrast, the reimbursement and RUVS of 76882 with modifier 26 are $25.21 and 0.72841 when furnished in the non-facility. In OPPS global, the cost and RUVS of CPT 76882 with modifier 26 are $25.21 and 0.72841.

The cost and RUVS of CPT 76882 with modifier TC are $40.11 and 1.15907 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 76882 with modifier TC are $40.11 and 1.15907 when furnished in the non-facility. In OPPS global, the cost and RUVS of CPT 76882 with modifier TC are $130.09 and 3.75921.

In OPPS global, the cost and RUVS of CPT 76882 with a global modifier are $65.32 and 1.88748. The cost and RUVS of CPT 76882 with global billing are $65.32 and 1.88748 when performed in the facility. In contrast, the reimbursement and RUVS of 76882 with global billing are $155.30 and 4.48762 when performed in the non-facility.

CPT codes 76881 and 76882 have both a technical and professional component. If the Physician performs the professional part only, append modifier 26. In contrast, If the Physician performs the technical role, append modifier TC. Submit without a modifier to report the complete procedure (i.e., professional and technical components).

76882 CPT Code Examples

The following are the examples when CPT code 76882  bills:

Example 1

A 60-year-old female presents with ankle pain for four days to the office. The pain gets worse with movement and when lying down. The patient took some medication for pain. 

The physical exam revealed swelling in the knee region. The Physician ordered a CT and ultras sound of the ankle, showing degeneration of the ankle joint. The patient also has effusion of both knees. The patient denies any other symptoms such as headache, numbness, urinary problems, nausea, vomiting, and shortness of breath. 

The Physician consulted with orthopedics and suggested total ankle arthroplasty. The Physician scheduled the total ankle arthroplasty for next week, and he was prescribed medications for further treatment. 

Example 2

A sixteen-year-old male presented to the emergency department after a motor vehicle accident today and had a severe headache, back pain, and shoulder. The patient is unable to move and has severe knee pain. 

The patient denies urinary symptoms, extremity pain, and dizziness, and the physical exam revealed neck and eye swelling. The Physician ordered a CT and ultrasound of the shoulder, head, and the Lumbar. It revealed traumatic injury of the Knee.

The Physician consulted with orthopedics and suggested total shoulder arthroplasty. The Physician scheduled the total shoulder arthroplasty for next week, and he was prescribed medications for further treatment. 

Example 3 

A 39-year-old male presents to the office with degenerative changes in the hip joint with c/o constant low back pain that started four days ago. The patient was unable to walk for 1-week. 

The patient is consulted with his primary care physician and suggested to go emergency department. Denies trauma, heavy palpitations, dizziness, cough, recent illness, fever, chills, back pain, abdominal pain, nausea, recent travel, known sick contacts, current antibiotic use, near-syncope or syncope, changes in stool color, urinary complaints, or any other symptoms. 

The Physician decides to do a surgical procedure to operate on the hip. The patient took his routine medication. The Physician ordered a CT scan and ultrasound of the hip joint to confirm if the patient has osteoarthritis. The procedure performs successfully.

The Physician consulted with orthopedics and suggested total hip arthroplasty. The Physician scheduled the total knee arthroplasty for next week, and he was prescribed medications for further treatment. 

Example 4

A 76-year-old male presents to the office for rheumatoid arthritis of the Knee. A patient has had severe right leg pain since last week. 

The patient took some medication for pain but is getting worse day by day. He denies trauma, heavy palpitations, dizziness, cough, recent illness, fever, chills, back pain, abdominal pain, nausea, recent travel, known sick contacts, current antibiotic use, near-syncope or syncope, changes in stool color, urinary complaints, or any other symptoms. 

The CT scans of the knee joint show degeneration, effusion, and other knee joint disorders. 

The Physician consulted with orthopedics and suggested total knee arthroplasty. The Physician scheduled the total knee arthroplasty for next week, and he was prescribed medications for further treatment. 

Example 5

A 65-year-old female presents to the office with wrist Osteoarthritis and pain. The pain gets worse with movement and when lying down. The patient took some medication for pain. The pain gets resolved for a few hours and starts again.

The patient denies any other symptoms such as headache, numbness, urinary problems, nausea, vomiting, and shortness of breath. A physical exam revealed swelling in the Knee region. 

The Physician ordered a CT scan and ultrasound of the wrist. It reveals knee joint degeneration, effusion, and other joint disorders. The Physician consulted with orthopedics and suggested total knee arthroplasty. The Physician scheduled the total wrist arthroplasty for next week, and he was prescribed medications for further treatment. 

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