Limited Transvaginal Ultrasound

One of our clients received information from your website that a repeat limited transvaginal ultrasound should be billed with a limited pelvic ultrasound code (76857). I am wondering if someone could verify that this information is accurate and let us know what that guidance is based upon. The American College of Radiology differentiates the two types of studies in the 2006 Ultrasound Coding User’s Guide. “The pelvic ultrasound using a full bladder as a window to the pelvis and a transvaginal ultrasound using a vaginal probe as a window to the pelvis are separately coded procedures. A common practice is for ultrasound departments to begin with a pelvic ultrasound performed through a full bladder and to supplement the examination with a transvaginal ultrasound. When the transvaginal examination is used as the only technique, use 76830 for the procedure.” 76830 Ultrasound, transvaginal 76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 76857 Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (e.g., for follicles)

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