Explanation of “Transabdominal” vs “Pelvic transabdominal” vs “Pelvic Transvaginal” Ultrasound studies.
When is a pelvic ultrasound (or sonogram) recommended?
INDICATIONS FOR PELVIC SONOGRAM TO EVALUATE UTERUS AND OVARIES.
- Painful Sex
- Pelvic pain
- Low back pain
- Irregular bleeding
- Mid-cycle bleeding
- Heavy bleeding
- IUD placement check
- Delayed periods
- Ovarian Cysts
- Uterine Fibroids
- Rule out Pregnancy
- Obesity/ Abdominal bloating – Unable to evaluate uterus on exam.
- Urinary Incontinence
- Pelvic Inflammatory disease (PID)
- Congenital abnormalities of genital tract (Uterus/ Ovaries)
What is included in a pelvic ultrasound and what are the codes associated with these studies?
Full Pelvic Ultrasound is a two part study as listed below. Both parts are important to complete a full evaluation of the pelvic organs.
- Pelvic abdominal ultrasound.
The CPT code for this is 76856.
This is a part of a the full pelvic ultrasound which includes visualization of the lower abdomen from the lower part of the abdomen and includes evaluation of uterus/ bladder and any other additional masses (if present) from the lower abdominal angle.
- Pelvic transvaginal ultrasound.
The CPT code for this is 76830
This is the second component of the full pelvic ultrasound. In this study, a vaginal probe is used to evaluate the uterus/ ovaries/ adnexal masses etc from the vagina.
Both the above studies are needed to a full pelvic evaluation and each are indicated by a separate CPT code hence billed separately since they are separate studies with different probes.
WE HAVE TO PERFORM BOTH OF THE ABOVE STUDIES TO COMPLETELY EVALUATE THE PELVIS.
Situations in which we may not do a Transvaginal sonogram:
- If you have never had vaginal intercourse (virgin).
- If you are actively bleeding from the vagina.
- If you are pregnant and you have placenta previa.
What is a 3D Ultrasound?
3D ultrasound (CPT- 76377) is done in addition if there are any masses, fibroids, IUD or any uterine pathology.
Basically it looks at a structure with a specialized setting from all directions so we can evaluate that structure with more accuracy. This requires a very advanced probe and setting, hence a different code.
What is a color doppler and why was it done?
A Color Doppler (CPT-93975) is done in addition if there is pelvic pain/ ovarian cyst/ mass/ tumor etc.
Essentially a color doppler looks for blood flow in and around the organ. This study is important in many cases to evaluate if the mass could be cancerous, or if there is an ectopic pregnancy or something else that shouldn’t be there. It also helps us evaluate life threatening condition of suspected ovarian torsion (twisting of ovary), which if not treated early can lead to permanent ovarian damage,
Does a pelvic ultrasound also check for my liver and gall bladder?
No. For that you need a complete abdominal ultrasound.
Complete abdominal ultrasound is indicated by CPT codes from 76801-76812
This includes a full exam of your upper and mid abdomen and organs such as gall bladder/ liver/ stomach etc.
WE DO NOT PERFORM THIS STUDY AT OUR FACILITY SINCE WE ARE A GYN (WOMEN’S HEALTH) FACILITY.
I thought ultrasound was included in my annual and its free!
NO!
Ultrasound is never considered preventative by your insurance. We agree that it is an important screening test but it’s not covered as “free” under your annual visit. Your out of pocket costs will apply to this diagnostic service. We didn’t make these rules. If you have questions regarding coverage and out of pocket costs, please feel free to call your insurance before scheduling your appointment
Hope this helps clarify your concerns. We are happy to give you a secure link with all the images and also a finalized report. Please note that the finalized report can take upto 10 days.
Sincerely
Walk IN GYN Team.