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The CPT® Code 76513 refers to a diagnostic ophthalmic ultrasound procedure specifically targeting the anterior segment of the eye. This procedure can be performed using two distinct techniques: the water bath immersion B-scan and high resolution biomicroscopy. In the water bath immersion method, a plastic eye cup is utilized, which is filled with a coupling medium such as methylcellulose or normal saline. This cup is placed between the eyelids to facilitate the ultrasound examination. The B-scan ultrasound is then employed to visualize the structures of the anterior segment. On the other hand, high resolution biomicroscopy involves the use of a higher frequency ultrasound transducer integrated into a B-mode clinical scanner, allowing for the generation of finely detailed images of the eye's anatomy. Both techniques are particularly valuable for obtaining intricate images of various ocular components, including the cornea, iris, sclera, ciliary bodies, and zonules. The clinical applications of this diagnostic procedure are extensive, encompassing the measurement of anterior chamber depth prior to cataract surgery and intraocular lens (IOL) implantation, evaluation of the iridocorneal angle in glaucoma patients, characterization of cystic and solid lesions in suspected tumors, identification of ocular foreign bodies, and mapping of anterior and posterior corneal elevations for refractive surgery. Additionally, the immersion B-scan technique is capable of penetrating opaque materials, such as cataracts and scars, thereby enhancing its diagnostic utility.
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The procedure described by CPT® Code 76513 is indicated for various clinical scenarios where detailed imaging of the anterior segment of the eye is necessary. The following conditions and symptoms may warrant the use of this diagnostic ultrasound:
The procedure associated with CPT® Code 76513 involves specific steps to ensure accurate imaging of the anterior segment of the eye. The following procedural steps are typically followed:
Post-procedure care following the diagnostic ultrasound is generally minimal, as the procedure is non-invasive and typically well-tolerated by patients. Patients may be advised to avoid rubbing their eyes and to report any unusual symptoms, such as persistent discomfort or changes in vision. Follow-up appointments may be scheduled to discuss the results of the ultrasound and to determine any necessary further evaluations or treatments based on the findings. It is important for healthcare providers to ensure that patients understand the significance of the results and any subsequent steps that may be required.
| Short Descr | OPH US DX ANT SGM US UNI/BI | Medium Descr | DX OPHTHALMIC US ANT SEGMENT IMMERSION UNI/BI | Long Descr | Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, unilateral or bilateral | 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 | 1 | CCS Clinical Classification | 192 - Diagnostic ultrasound of head and neck |
| 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). | LT | Left side (used to identify procedures performed on the left side of the body) | 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. | 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). | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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. | 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. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CG | Policy criteria applied | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 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 | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2021-01-01 | Changed | Code changed. |
| 2011-01-01 | Changed | Short description changed. Guideline information changed. |
| 2005-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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