Proper coding for ultrasound to rule out or follow-up on AAA; plus other CPT codes for related, other organ and duplex studies

Q.

Which is the correct CPT^® code that should be used for the ultrasound imaging of the aorta to rule out abdominal aortic aneurysm (AAA) or to follow-up a known AAA: CPT 76775 or 93978?

A.

For a screening exam for AAA, report CPT code 76706. The code and full description are:

76706 Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA)

For other than screening. it could be one of several CPT codes depending on what is actually performed. These include CPT codes 76770, 76775, 93978, and 93979.

If you perform only a limited grayscale ultrasound to look at/measure the abdominal aorta, then it would be CPT code 76775. If you perform a complete retroperitoneal exam including imaging of the kidneys, common iliac artery origins, and the inferior vena cava as well as the abdominal aorta, then you would report CPT code 76770. Here are the codes and full descriptions:

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

76775 Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited

If you provide a duplex scan (including grayscale imaging of the vascular structure, color Doppler and spectral analysis), then you would assign CPT code 93978 if you evaluated the entire abdominal course of the aorta, or 93979 if you only evaluated a segment. Here are the codes and full descriptions:

93978 Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study

93979 Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study