How To Use CPT Code 76775

CPT 76775 is a limited retroperitoneal ultrasound code used for assessing specific abdominal structures with real-time image documentation. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 76775.

1. What is CPT 76775?

CPT 76775 is a medical billing code used for limited retroperitoneal ultrasounds, which are noninvasive diagnostic procedures that assess specific structures within the abdominal cavity, such as the kidneys, aorta, or lymph nodes. This code is utilized when real-time image documentation is required for a limited examination of these structures.

2. 76775 CPT code description

The official description of CPT code 76775 is: “Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited.”

3. Procedure

The 76775 procedure involves the following steps:

1. The patient is positioned appropriately for the ultrasound examination.
2. A conductive gel is applied to the skin over the area to be examined, which helps transmit sound waves.
3. An ultrasound machine sends high-frequency sound waves through a probe called a transducer.
4. The transducer is pressed against the skin and moved over the area being studied to produce the desired image on the monitor.
5. Real-time images of the specific retroperitoneal structures (e.g., kidneys, aorta, or lymph nodes) are captured and documented.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 76775 services include those with suspected or confirmed medical conditions involving the kidneys, aorta, or lymph nodes within the retroperitoneal space. Examples of such conditions may include kidney stones, aortic aneurysms, or enlarged lymph nodes due to infection or malignancy. The limited retroperitoneal ultrasound may also be used for follow-up examinations or monitoring of previously diagnosed conditions.

5. When to use CPT code 76775

It is appropriate to bill the 76775 CPT code when a limited retroperitoneal ultrasound is performed to assess specific structures within the abdominal cavity, such as the kidneys, aorta, or lymph nodes, and real-time image documentation is required. This code should not be used for complete retroperitoneal ultrasounds, which involve a more comprehensive examination of the abdominal structures.

6. Documentation requirements

To support a claim for CPT 76775, the following information should be documented:

• Patient’s medical history and presenting symptoms
• Indication for the limited retroperitoneal ultrasound
• Specific structures examined (e.g., kidneys, aorta, or lymph nodes)
• Findings and observations from the ultrasound examination
• Real-time images captured during the procedure
• Interpretation and conclusions drawn from the ultrasound findings

7. Billing guidelines

When billing for CPT code 76775, keep in mind the following guidelines:

• If only the physician’s interpretation of the radiology service is being reported, append professional component modifier 26 to the radiology code.
• If only the technical component of the radiology service is being reported, append modifier TC to the radiology code. Note that some payer policies may exempt hospitals from appending modifier TC, as the hospital’s portion is inherently technical.
• Do not append a professional or technical modifier to the radiology code when reporting a global service in which one provider renders both the professional and technical components.

8. Historical information

CPT 76775 was added to the Current Procedural Terminology system on January 1, 1990. The code has undergone the following changes:

• Code Changed on 01-01-2002: Echography, retroperitoneal (eg, renal, aorta, nodes), B-scan and/or real time with image documentation; limited
• Code Changed on 01-01-2007: Ultrasound, retroperitoneal (eg, renal, aorta, nodes), B-scan and/or real time with image documentation; limited

9. Similar codes to CPT 76775

Five similar codes to CPT 76775 and how they differentiate are:

• CPT 76770: A complete retroperitoneal ultrasound that involves a comprehensive examination of the kidneys, abdominal aorta, and urinary bladder.
• CPT 76776: A retroperitoneal ultrasound with Doppler and color flow imaging, which provides additional information on blood flow within the examined structures.
• CPT 93975: A duplex scan of the abdominal aorta, which combines ultrasound imaging with Doppler evaluation of blood flow.
• CPT 93976: A limited duplex scan of the abdominal aorta, focusing on a specific area or issue.
• CPT 76705: An abdominal ultrasound that examines multiple organs within the abdominal cavity, not limited to the retroperitoneal space.

10. Examples

Here are 10 detailed examples of CPT code 76775 procedures:

1. A patient presents with flank pain, and a limited retroperitoneal ultrasound is performed to assess the kidneys for possible kidney stones.
2. A patient with a history of aortic aneurysm undergoes a limited retroperitoneal ultrasound to monitor the size and stability of the aneurysm.
3. A patient with unexplained weight loss and enlarged abdominal lymph nodes undergoes a limited retroperitoneal ultrasound to evaluate the lymph nodes for possible malignancy.
4. A patient with a history of kidney transplant undergoes a limited retroperitoneal ultrasound to assess the transplanted kidney’s function and blood flow.
5. A patient with suspected renal artery stenosis undergoes a limited retroperitoneal ultrasound to evaluate the renal arteries.
6. A patient with a history of abdominal aortic aneurysm repair undergoes a limited retroperitoneal ultrasound to monitor the repair site for complications or recurrence.
7. A patient with a known renal mass undergoes a limited retroperitoneal ultrasound to monitor the size and characteristics of the mass over time.
8. A patient with suspected hydronephrosis undergoes a limited retroperitoneal ultrasound to assess the kidneys for signs of obstruction or dilation.
9. A patient with a history of lymphoma undergoes a limited retroperitoneal ultrasound to monitor the size and number of abdominal lymph nodes during treatment.
10. A patient with unexplained hematuria undergoes a limited retroperitoneal ultrasound to evaluate the kidneys and urinary bladder for possible causes.