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Ultrasound elastography is a specialized imaging procedure that utilizes ultrasound technology to assess the elastic properties of soft tissues, including lesions within various organs. This technique is particularly valuable for evaluating the parenchyma, which refers to the functional tissue of an organ, such as the liver, breast, thyroid, prostate, and muscles. By measuring the stiffness or elasticity of these tissues, healthcare providers can gain critical diagnostic insights into potential diseases or abnormalities. There are several elastography ultrasound (EUS) techniques employed to create both qualitative and quantitative images of the target tissue. One common method is strain elastography, which visualizes tissue elasticity in real-time by applying low-frequency compression through a handheld ultrasound transducer or by utilizing natural physiological movements, such as breathing or pulsation, to induce tissue displacement. This approach is primarily used for musculoskeletal imaging. Another technique, known as acoustic radiation force impulse (ARFI) elastography, involves the use of focused ultrasound pulses to internally excite the tissue, resulting in a color-coded or gray-scale image that reflects tissue stiffness. ARFI is particularly effective for deep-tissue imaging, including assessments of the liver, thyroid, and breast. Additionally, shear wave elasticity imaging (SWEI) employs ultrasound waves that travel sideways through the tissue to generate images, making it suitable for deep-tissue evaluations. A variant of SWEI, called transient vibration controlled elastography, utilizes short bursts of vibration to enhance imaging of the liver. It is important to note that CPT® Code 76981 is designated for the evaluation of a parenchymal organ and any specific lesions within that organ, while CPT® Code 76982 is used for the evaluation of a specific soft tissue lesion or the first lesion in a different organ. For each additional target lesion, CPT® Code 76983 should be utilized.
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The ultrasound elastography procedure is indicated for various conditions and symptoms that necessitate the assessment of tissue elasticity and stiffness. These indications include:
The ultrasound elastography procedure involves several key steps to ensure accurate assessment of the target lesion. These steps include:
After the ultrasound elastography procedure, patients may be monitored briefly to ensure there are no immediate adverse effects. Typically, there are no specific post-procedure care requirements, and patients can resume normal activities immediately. The results of the elastography will be reviewed by the physician, who will discuss the findings with the patient and determine any necessary follow-up actions or additional diagnostic steps based on the results obtained. It is essential for the healthcare provider to communicate the implications of the findings and any further evaluations that may be warranted.
| Short Descr | USE 1ST TARGET LESION | Medium Descr | ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION | Long Descr | Ultrasound, elastography; first target lesion | 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) | 4 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic imaging procedures apply... | Bilateral Surgery (50) | 0 - 150% 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 | 88 - | APC Status Indicator | Codes That May Be Paid Through a Composite APC | ASC Payment Indicator | Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS relative payment weight. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
This is a primary code that can be used with these additional add-on codes.
| 0690T | Add-on Code MPFS Status: Carrier Priced APC N Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (List separately in addition to code for primary procedure) | 76983 | Add-on Code MPFS Status: Active Code APC N ASC N1 Ultrasound, elastography; each additional target lesion (List separately in addition to code for primary procedure) |
| 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. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 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). | 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. | 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 | RT | Right side (used to identify procedures performed on the right side of the body) | LT | Left side (used to identify procedures performed on the left side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | 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 | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter |
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| 2019-01-01 | Added | Added |
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