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Ophthalmic ultrasound (US) is a diagnostic imaging technique that employs high-frequency sound waves to create detailed images of the eye's internal structures. This method is particularly valuable for assessing acute vision-threatening conditions or identifying abnormal pathologies that may be discovered during routine eye examinations. The unique fluid-filled composition of the eye enhances the acoustic properties, allowing for high-resolution imaging. Ophthalmic ultrasound can serve as the primary diagnostic tool for detecting anomalies within the eye or act as a complementary method alongside other imaging modalities such as MRI and CT scans. The quantitative A-scan ultrasound, specifically denoted by CPT® Code 76511, utilizes a time amplitude technique to generate vertical lines along a baseline by directing thin, parallel sound beams toward a targeted area of tissue. This A-scan imaging technique is instrumental in differentiating between various intraocular structures, including tumors, extraocular muscles, and the optic nerve. Additionally, it is useful for measuring the thickness of the lacrimal gland, evaluating the paranasal sinus and nasolacrimal systems, and assessing the post-scleral and sub-Tenon's space. In contrast, the B-scan ultrasound employs a brightness amplitude technique, producing pixelated images on a computer screen that represent the echoes of the oscillating sound beam. This method is effective for analyzing the shape and anatomical relationships of intraocular structures, identifying foreign bodies, detecting unusual calcium deposits, and diagnosing conditions such as anterior orbital tumors and myositis-induced tendon thickening. The B-scan can also reveal enlargement of the superior ophthalmic vein. When used together, A-scan and B-scan can be superimposed to enhance the diagnostic evaluation of ocular tumors, tissue detachment, cataracts, and traumatic injuries. It is important to note that CPT® Code 76510 is applicable when both B-scan and quantitative A-scan are performed in a single session, while CPT® Code 76512 is designated for B-scan procedures that may or may not include superimposed non-quantitative A-scan.
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Ophthalmic ultrasound, specifically the quantitative A-scan, is indicated for various clinical scenarios where detailed imaging of the eye is necessary. The following conditions and symptoms may warrant the use of this diagnostic tool:
The procedure for performing a quantitative A-scan ultrasound involves several key steps that ensure accurate imaging and assessment of the eye's internal structures. The following outlines the procedural steps:
After the quantitative A-scan ultrasound procedure, there are several considerations for post-procedure care and follow-up. Patients may experience minimal discomfort, but generally, there are no significant side effects associated with the procedure. The clinician may provide instructions regarding any necessary follow-up appointments or additional imaging studies if required. It is important for the clinician to review the ultrasound findings with the patient, discussing any implications for their ocular health and potential treatment options based on the results. Patients should be advised to report any unusual symptoms or changes in vision following the procedure, ensuring timely intervention if needed.
| Short Descr | OPH US DX QUAN A-SCAN ONLY | Medium Descr | OPHTHALMIC US DX QUANTITATIVE A-SCAN ONLY | Long Descr | Ophthalmic ultrasound, diagnostic; quantitative A-scan only | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 7 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic ophthalmology services apply... | Bilateral Surgery (50) | 3 - The usual payment adjustment for bilateral procedures does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | STV-Packaged Codes | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I3A - Echography/ultrasonography - eye | MUE | 2 | CCS Clinical Classification | 192 - Diagnostic ultrasound of head and neck |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | GW | Service not related to the hospice patient's terminal condition | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician |
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| 2021-01-01 | Changed | Short and medium descriptions changed. |
| 2011-01-01 | Changed | Short description changed. |
| 2005-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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