Ultrasound, abdominal, complete
Audit Defense & Denial Intelligence
Research-based denial patterns from OrbDoc Bill Analyzer
1. Abdominal ultrasound billed as complete when limited exam performed
Very Common76700 (ultrasound abdomen complete) requires imaging of liver, gallbladder, common bile duct, pancreas, spleen, kidneys, aorta, and IVC. Denied when documentation shows limited study (single organ focus), when technical factors prevent complete visualization, or when exam focused on pelvis. Complete = all listed structures evaluated and documented.
Common Causes
- • Report documents gallbladder and liver only - that's limited 76705, not complete 76700
- • Study for suspected appendicitis focused on RLQ - limited exam even if multiple structures seen
- • Bowel gas obscured pancreas/aorta but billed as complete - must bill limited if structures not visualized
Resolution Strategy
Document complete exam: 'Complete abdominal ultrasound. Liver: normal size and echogenicity, no focal lesions. Gallbladder: no stones, wall normal. Common bile duct: 4mm, normal caliber. Pancreas: partially obscured by bowel gas, visualized portions normal. Spleen: normal size. Right kidney: 11cm, no hydronephrosis or stones. Left kidney: 10.5cm, normal. Aorta: normal caliber, no aneurysm. IVC: patent.' Must document ALL structures or explain why not visualized. If any structure not evaluated due to technical factors, may need to bill limited 76705. For focused single-organ exams, use limited code. Appeal with amended report documenting complete exam only if all structures actually imaged.
💬 Plain Language Explanation
What this means
This is an ultrasound of your abdomen - an imaging test that uses sound waves to create pictures of your abdominal organs (liver, kidneys, gallbladder, etc.).
Why you might see this
This is a common imaging test. Your doctor likely ordered this to check your abdominal organs, often done when you have abdominal pain, to check for gallstones, or to monitor organ health.
Common context
Common imaging test for checking abdominal organs, often used for abdominal pain or to check for gallstones.
What to ask your provider
"'What did the ultrasound show? Were there any abnormalities in my abdominal organs?'"
Relative Value Units (RVUs)
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Clinical Information
When to Use
For complete abdominal ultrasound
Common Scenarios
Documentation Requirements
- Indication for abdominal ultrasound
- Complete abdominal evaluation
- All organs documented
- Findings and interpretation
- Report documentation
Coding Guidelines
Common Modifiers
Bundling Rules
- Includes complete abdominal ultrasound
- Includes interpretation and report
- All abdominal organs included
- Limited abdominal ultrasound coded separately
- CT abdomen coded separately
Exclusions
- 76705 (ultrasound, abdominal, limited)
- 76770 (ultrasound, retroperitoneal, complete)
- 76536 (ultrasound, soft tissues of head and neck)
- 76805 (ultrasound, pregnant uterus, complete)
Coding Notes
Medical Necessity: ICD-10
Clinical scenarios
- Indication for abdominal ultrasound
- Complete abdominal evaluation
- All organs documented
- Indication for abdominal ultrasound
- Complete abdominal evaluation
- All organs documented
- Indication for abdominal ultrasound
- Complete abdominal evaluation
- All organs documented
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Code Details
Medicare Pricing
PFSRVU Breakdown
OPPS Details
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Ask a QuestionFrequently Asked Questions
CPT 76700 is the billing code for "Ultrasound, abdominal, complete". For complete abdominal ultrasound
Medicare pays approximately $111.92 for CPT 76700 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.
CPT 76700 has a total RVU of 3.77, broken down as: Work RVU 0.70, Practice Expense RVU 3.00, and Malpractice RVU 0.07. RVUs (Relative Value Units) determine Medicare reimbursement rates.
The most common denial reason for CPT 76700 is "Abdominal ultrasound billed as complete when limited exam performed". 76700 (ultrasound abdomen complete) requires imaging of liver, gallbladder, common bile duct, pancreas, spleen, kidneys, aorta, and IVC. Denied when documentation shows limited study (single organ focus), when technical factors prevent complete visualization, or when exam focused on pelvis. Complete = all listed structures evaluated and documented. Common causes include: Report documents gallbladder and liver only - that's limited 76705, not complete 76700; Study for suspected appendicitis focused on RLQ - limited exam even if multiple structures seen. Appeal success rate is approximately 40-60%.
Key documentation requirements for CPT 76700 include: Indication for abdominal ultrasound; Complete abdominal evaluation; All organs documented; Findings and interpretation. Missing or incomplete documentation is a leading cause of claim denials for this code.
Bundling considerations for CPT 76700: Includes complete abdominal ultrasound. Includes interpretation and report Use an NCCI bundling checker to verify specific code combinations before billing.
Common modifiers for CPT 76700 include: 26 (Professional component only (interpretation)), TC (Technical component only (equipment/staff)), 59 (Distinct procedural service if performed separately). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.
The typical time requirement for CPT 76700 is 20-30 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.