Coding for non-diagnostic reduced-service exams

Q.

For ultrasound exams that are non-diagnostic due to gas, body habitus, etc. is it appropriate to down code to a limited exam (if ordered as complete) and append a modifier 52?

A.

If you change the code to limited, you really don’t need the 52 modifier because 52 is “reduced service,” and limited exams are already reduced services – anything less than complete. If you decide to bill those non-diagnostic exams you can report a limited CPT^® code (e.g., 76705 instead of 76700) if there is one, or add modifier 52 if there is no limited exam code (e.g., 76604–52).