Article ID: 56671
Article Title: Billing and Coding: Nonobstetric Pelvic Ultrasound
Article Type: Billing and Coding
Original Effective Date: 07/04/2019
Revision Effective Date: 10/01/2022
Revision Ending Date: N/A
Retirement Date: N/A
The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Nonobstetric Pelvic Ultrasound L37636.
Indications
76856 is a complete evaluation and must minimally include:
- Female: description and measurements of the uterus and adnexal structures, measurement of the endometrium and bladder, and a description of any pelvic pathology.
- Male: evaluation and measurement of the bladder, evaluation of the prostate and seminal vesicles and any pelvic pathology.
76857 is a limited study and typically focuses on one or more elements listed under 76856 and/or the reevaluation of one or more pelvic abnormalities.
Limitations
- Post voiding residual bladder volume is not reimbursable by CPT® codes 76856 and 76857. Measurement of post voiding residual should be billed using CPT® code 51798.