The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for the Retroperitoneal Ultrasound L34577.
A full (complete) or limited abdominal ultrasound (US) (CPT® 76700, 76705, 76706*), views all structures in the abdomen including those in the retroperitoneal area. Frequently when a retroperitoneal US is performed findings encountered during the exam may warrant that the exam be expanded to become a full abdominal study.
It is expected that CPT® 76770, 76775, 76776 will only be billed when the exam has been limited to retroperitoneal structures. Exams that include structures other than or in addition to, those listed above should be billed as a full (complete) or appropriately limited abdominal US (CPT® 76700, 76705, 76706*).
It is not appropriate to bill for both a retroperitoneal US study AND a complete (or limited) abdominal US when a retroperitoneal US study is expanded to include organs and structures outside the retroperitoneum.
Utilization Guidelines
If the physical exam has primary findings for the involvement of non-retroperitoneal structures/organs (gallbladder, liver, spleen, common bile duct, etc.), even though it may be necessary to visualize retroperitoneal structures in the course of the procedure, a full abdominal US would be required in most cases to be diagnostic, and that is the procedure that should be performed and billed.