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Question:
For ultrasound exams that are non-diagnostic due to gas, body habitus, etc. is it appropriate to down code to a limited exam (if ordered as complete) and append a modifier 52?
Answer:
If you change the code to limited, you really don’t need the 52 modifier because 52 is “reduced service,” and limited exams are already reduced services – anything less than complete. If you decide to bill those non-diagnostic exams you can report a limited CPT® code (e.g., 76705 instead of 76700) if there is one, or add modifier 52 if there is no limited exam code (e.g., 76604-52).
CPT® copyright 2023 American Medical Association (AMA). All rights reserved.
Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
CPT is a registered trademark of the American Medical Association.
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