Coding

  • 1.  anatomy survey

    Posted 11-17-2022 16:22
    I have a question, 

    For CPT code 76811 do we only bill it out if they are able to get every picture listed for an anatomy scan?
    If they are unable to get every picture and the patients has to come back for a follow up anatomy to get the rest of the pictures do we still use 76811 or do we use 76805? 

    Thank you very much

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    David PRINCIPE
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  • 2.  RE: anatomy survey

    Posted 11-17-2022 20:55
    In the first attempt at 76811, the report should comment on every required element, whether normal, abnormal, or suboptimally visualized, etc.. Billing 76811 would then be appropriate. You should indicate why some of the anatomy was suboptimally seen (e.g. habitus, position, etc.). The follow-up study to image the anatomy that was not well seen in the first attempt would be billed as 76816.
    Best,

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    Fadi BSAT, MD, FAIUM
    Chair, SMFM Practice Management Committee
    Immediate past Chair, SMFM Coding Committee
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    Original Message


  • 3.  RE: anatomy survey

    Posted 11-18-2022 09:57
    Hi David
    I see Fadi answered you in this forum (Coding)
    I think you also cross posted in the PM forum and I answered the question there: 
    You can bill out the 76811, you just must list what structures were obtained/visualized/cleared and what was suboptimal 
    You must ATTEMPT to visualize all structures though - which is why being clear with what was seen/not seen will help justify your code selection.  When you bring them back you would bill the 76816 - follow-up on previous anatomy not cleared. 


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    Vanita Jain, MD
    Chair, SMFM Coding Committee
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    Original Message