If left and right ultrasound exams for pleural effusions is performed, is it appropriate to report two units of code 76604? The code description states “includes mediastinum,” does that make it a unilateral or bilateral code?
If left and right examinations of the chest are performed, it is inappropriate to report two units of code 76604 as the code encompasses the entire chest area. Code 76604 is frequently used for (but is not limited to) evaluations of pleural effusions, mediastinal masses, and masses in the chest or the chest wall. The inclusion of the term “includes mediastinum” in the code description indicates that when the examination includes the mediastinum it should not be reported separately. Keep in mind that in cases where the exam is performed for pleural effusion, limited modifier 52 is not necessary.
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