Guidelines for Ordering Ultrasounds

Ultrasound Exam Body Parts Included Common Indications Exam Preparations

Goiter
• Thyroid gland Hypothyroidism
Thyroid or Soft Tissue Neck • Cervical lymph nodes Hyperthyroidism
NO PREP
CPT: 76536 • Focused ultrasound to the area Thyroid nodule(s)
of concern Follow-up thyroid nodule(s)
Cervical lymphadenopathy
TIA
Carotid • Bilateral carotid artery Stroke
NO PREP
CPT: 93880 • Duplex / Doppler HTN
Atherosclerotic disease

• Pancreas
• Liver
• Gallbladder
Abdominal pain, unspecified
• Bile duct
Abdomen Complete Epigastric pain
• Right kidney Fast for 6 hours
CPT: 76700 Flank pain
• Left kidney
Nonspecific abdominal symptoms
• Spleen
• Aorta (Limited)
• IVC (Limited)

• Pancreas
RUQ pain
• Liver
Epigastric pain
RUQ Ultrasound • Gallbladder
Abnormal LFTs
(Abdomen, Limited) • Bile duct Fast for 6 hours
Jaundice
CPT: 76705 • Right kidney
Liver abnormality seen on other imaging
• Aorta (Limited)
HCC screening
• IVC (Limited)

• Pancreas
• Liver
• Gallbladder
• Bile duct Hepatic cirrhosis
Liver Ultrasound
• Right kidney Chronic viral hepatitis
(Abdomen, Limited with Complete Doppler) Fast for 6 hours
• Aorta (Limited) Portal hypertension
CPT: 76705 93975
• IVC (Limited) Hemochromatosis
• Complete Doppler of the
hepatic vasculature (hepatic
veins, hepatic artery, portal vein)

• Pancreas
• Liver
• Gallbladder Hepatic cirrhosis
Liver Elastography • Bile duct Chronic viral hepatitis
(With Right Upper Quadrant Ultrasound and • Spleen Steatohepatitis
Fast for 6 hours
Complete Doppler) • Aorta (Limited) Fatty liver disease
CPT: 76705 93975 76981 • IVC (Limited) Liver staging
• Complete Doppler of the *US of choice to evaluate hepatic fibrosis
hepatic vasculature (hepatic
veins, hepatic artery, portal vein)

Ultrasound Aorta Diagnostic

Pulsatile abdominal mass
(Retroperitoneum, Limited) • Aorta Fast for 6 hours
AAA follow-up
CPT: 76775
Ultrasound Aorta Screening
AAA screening
(Retroperitoneum, Limited) • Aorta Fast for 6 hours
Family history
CPT: 76706
Flank pain
• Right kidney Hematuria
Kidneys Ultrasound • Left kidney Kidney stones
(Retroperitoneum, Limited) Renal cysts NO PREP
CPT: 76775 Not included: Renal abnormality seen on other imaging
• Urinary bladder Renal disease (CKD)
UTI
• Right kidney
Kidney Ultrasound and Renal Arteries WITH • Left kidney
Complete Doppler • Complete Doppler of the renal Primary hypertension Fast for 6 hours
June 2021

CPT: 76775 93975 arteries, renal veins and intrarenal

vessels

401.432.2400
Disclaimer: The information contained in this document represents the most common current procedural terminology codes
®
w w w. r i m i r a d . c o m utilized but is not all inclusive. Other codes do apply. This is provided solely for assistance and easy access to information.
 Guidelines for Ordering Ultrasounds
Ultrasound Exam Body Parts Included Common Indications Exam Preparations
• Right kidney Hematuria
The patient must finish drinking 3 (8 OZ) glasses
Kidneys Ultrasound and Bladder • Left kidney UTI
of any liquid 1 hour prior to appointment and
CPT: 76770 • Urinary bladder Post void residual
not empty bladder. The patient may eat.
• Post void residual Incontinence
The patient must finish drinking 3 (8 OZ) glasses
Bladder Ultrasound • Urinary bladder Post void residual
of any liquid 1 hour prior to appointment and
CPT: 76857 • Post void residual Incontinence
not empty bladder. The patient may eat.
Dysfunctional uterine bleeding
Post menopausal bleeding
Pelvic Ultrasound Transvaginal AND Uterine fibroids
• Bilateral ovaries The patient must finish drinking 3 (8 OZ) glasses
Transpelvic WITHOUT Doppler Ovarian adnexal cysts, mass
• Bilateral adnexa of any liquid 1 hour prior to appointment and
(<18 Years Old Transpelvic Only) Ovarian / adnexal abnormality seen on other imaging
• Uterus not empty bladder. The patient may eat.
CPT: 76856 76830 Pelvic mass
Polycystic ovary disease
Ovarian follicles monitoring

Pelvic Ultrasound Transvaginal AND • Bilateral ovaries The patient must finish drinking 3 (8 OZ) glasses
Transpelvic WITH Doppler • Bilateral adnexa Suspected ovarian torsion of any liquid 1 hour prior to appointment and
CPT: 76856 76830 93975 • Uterus not empty bladder. The patient may eat.

OB < 14 Weeks • Bilateral ovaries The patient must finish drinking 3 (8 OZ) glasses
Viability
(Includes Transvaginal AND Transpelvic) • Bilateral adnexa of any liquid 1 hour prior to appointment and
Dating
CPT: 76815 76817 • Uterus not empty bladder. The patient may eat.

Scrotal lump / mass / swelling

Scrotal Ultrasound WITHOUT Doppler • Bilateral testicles Hydrocele
NO PREP
CPT: 76870 • Bilateral epididymitis Varicocele
Undescended testicle
• Bilateral testicles Suspected torsion
Scrotal Ultrasound WITH Complete Doppler
• Bilateral epididymitis Scrotal pain NO PREP
CPT: 76870 93975
• Testicular vasculature Scrotal trauma
Venous Upper / Lower Extremity
DVT
Unilateral CPT: 93971 • Venous Duplex / Doppler NO PREP
Limb pain / swelling
Bilateral CPT: 93970

Hernia / Palpable Abnormality

Abdominal Hernia (Abdomen Limited) • Focused ultrasound to the area
Umbilical Hernia NO PREP
CPT: 76705 of concern
Inguinal Hernia (Extremity, Nonvascular) • Focused ultrasound to the area
Inguinal Hernia NO PREP
CPT: 76882 of concern
Chest / Upper Back • Focused ultrasound to the area
Lump NO PREP
CPT: 76604 of concern
Lower Abdomen / Lower Back • Focused ultrasound to the area
Lump NO PREP
CPT: 76705 of concern
Palpable lump (groin extremity)
Groin lymphadenopathy
Upper / Lower Extremity Nonvascular • Focused ultrasound to the area
Baker’s cyst NO PREP
CPT: 76882 of concern
Foreign body
Ganglion cyst

MSK / Musculoskeletal
Hand / Wrist Suspected radial / ulnar nerve injury
NO PREP
CPT: 76881 Suspected tendon injury
Biceps rupture
Elbow
Bursitis NO PREP
CPT: 76881
Suspected ulnar nerve abnormality
Rotator cuff tear
Shoulder Biceps rupture
NO PREP
CPT: 76881 Bursitis
Muscle strain
Morton’s neuroma
Foot
Plantar fasciitis NO PREP
CPT: 76881
Muscle strain
Ankle Suspected achilles injury
NO PREP
CPT: 76881 Suspected medial / lateral ankle tendon injury
June 2021

Knee Suspected patellar tendon injury

NO PREP
CPT: 76881 Suspected quadriceps injury

401.432.2400
Disclaimer: The information contained in this document represents the most common current procedural terminology codes
®
w w w. r i m i r a d . c o m utilized but is not all inclusive. Other codes do apply. This is provided solely for assistance and easy access to information.