Renal ultrasound of bladder

Q.

When we perform a renal ultrasound/ bladder with post-void imaging, do we assign multiple CPT^® codes, for example, codes 76770 and 51798? The bladder is part of our renal protocol; post void is not. If the patient only has a bladder/post-void, do we assign CPT code 51798 only?

A.

CPT code 51798 is a non-imaging measurement of post-void volume. It is rarely, if ever, used in radiology.

The code and full description are as follows:

51798 Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging

If you are submitting CPT code 76770 for a renal ultrasound, it requires both a bilateral kidney ultrasound and a bladder ultrasound. The bladder portion would include the post-void residual, if performed. If only post-void residual is measured through bladder imaging, that would be defined by CPT code 76857.

The codes and full descriptions are as follows:

76770   Ultrasound, retroperitoneal (e.g., renal, aorta, nodes), real time with image documentation; complete

76857   Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (e.g., for follicles)