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Ophthalmic ultrasound, specifically the B-scan diagnostic procedure, utilizes high-frequency sound waves to generate detailed images of the eye's internal structures. This imaging technique 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 effectiveness of ultrasound, allowing for high-resolution imaging. Ophthalmic ultrasound can serve as the primary diagnostic method for detecting anomalies within the eye or act as a complementary tool alongside other imaging modalities such as MRI and CT scans. The A-scan component of this procedure employs time amplitude ultrasound to create vertical lines along a baseline, utilizing thin, parallel sound beams directed at specific tissue areas. This A-scan image is instrumental in differentiating between various intraocular tumors, assessing extraocular muscles, and evaluating the optic nerve, as well as measuring the thickness of the lacrimal gland and examining the paranasal sinus and nasolacrimal systems. In contrast, the B-scan employs a brightness amplitude ultrasound technique, where an oscillating sound beam produces echoes that appear as pixelated images on a computer screen. This method is effective for analyzing the shape and anatomical relationships of intraocular structures, detecting foreign bodies, identifying unusual calcium deposits, and diagnosing anterior orbital tumors, tendon thickening due to myositis, and enlargement of the superior ophthalmic vein. The B-scan can be used in conjunction with the A-scan, allowing for superimposition of the two techniques to enhance the diagnostic process for ocular tumors, tissue detachment, cataracts, and traumatic injuries. The specific CPT® code 76512 is designated for the B-scan procedure, which may be performed with or without the inclusion of a non-quantitative A-scan.
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Evaluation of Acute Vision-Threatening Conditions The B-scan ultrasound is indicated for assessing conditions that pose an immediate risk to vision, allowing for timely intervention.
Identification of Abnormal Pathology This procedure is performed to detect abnormal findings during routine eye examinations, facilitating early diagnosis and treatment.
Assessment of Intraocular Structures The B-scan is utilized to analyze the shape and anatomical relationships of intraocular structures, which is crucial for accurate diagnosis.
Detection of Foreign Bodies The procedure is effective in identifying foreign bodies within the eye, which may require surgical intervention.
Diagnosis of Tumors B-scan ultrasound aids in the identification of anterior orbital tumors and intraocular tumors, providing essential information for treatment planning.
Evaluation of Tendon Thickening The procedure can be used to assess tendon thickening due to myositis, which may affect ocular movement.
Assessment of Vascular Structures Enlargement of the superior ophthalmic vein can be evaluated using B-scan ultrasound, which is important for diagnosing vascular conditions.
Step 1: Patient Preparation The patient is positioned comfortably, and the eye to be examined is prepared for the ultrasound procedure. This may involve the application of a coupling gel to enhance sound wave transmission.
Step 2: B-scan Ultrasound Application The ultrasound transducer is placed on the surface of the eye, and high-frequency sound waves are emitted. The echoes produced by the sound waves as they bounce off the internal structures of the eye are captured and processed to create images.
Step 3: Image Acquisition The B-scan generates pixelated images on a computer screen, allowing the clinician to visualize the intraocular structures. The operator may manipulate the transducer to obtain various angles and views for comprehensive assessment.
Step 4: Superimposition with A-scan (if applicable) If a non-quantitative A-scan is performed, the images from both the B-scan and A-scan may be superimposed to provide additional diagnostic information regarding ocular tumors, tissue detachment, and other conditions.
Step 5: Interpretation of Results The acquired images are analyzed by the clinician to identify any abnormalities, such as tumors, foreign bodies, or other pathological conditions. The findings are documented for further evaluation and treatment planning.
After the B-scan ultrasound procedure, the patient may resume normal activities immediately, as there are typically no restrictions or recovery time required. The clinician will review the ultrasound images and provide a report detailing the findings. Any necessary follow-up appointments or additional diagnostic tests will be discussed based on the results of the B-scan. Patients may be advised to monitor for any changes in vision or discomfort and to report these to their healthcare provider promptly.
| Short Descr | OPH US DX B-SCAN | Medium Descr | OPHTHALMIC US DX B-SCAN W/WO NON-QUAN A-SCAN | Long Descr | Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan) | 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 |
| LT | Left side (used to identify procedures performed on the left side of the body) | 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). | 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. | 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.) | 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 | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | GW | Service not related to the hospice patient's terminal condition | 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). | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | GA | Waiver of liability statement issued as required by payer policy, individual case | X2 | Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services | 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 | 55 | Postoperative management only: when 1 physician or other qualified health care professional performed the postoperative management and another performed the surgical procedure, the postoperative component may be identified by adding modifier 55 to the usual procedure number. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | E2 | Lower left, eyelid | E4 | Lower right, eyelid | ER | Items and services furnished by a provider-based, off-campus emergency department | FT | Unrelated evaluation and management (e/m) visit on the same day as another e/m visit or during a global procedure (preoperative, postoperative period, or on the same day as the procedure, as applicable). (report when an e/m visit is furnished within the global period but is unrelated, or when one or more additional e/m visits furnished on the same day are unrelated) | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | QJ | Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b) | U6 | Medicaid level of care 6, as defined by each state | 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 | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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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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