Here’s why an exam that lacks an ECG isn’t a FAST exam.
If you’re looking at a claim for a focused assessment with sonography for trauma (FAST) exam, coding quickly gets tricky if you don’t know the basics.
The skinny: Physicians — often emergency department (ED) physicians — perform FAST exams to check for internal bleeding. This exam typically involves a check for either bleeding in the peritoneal cavity or bleeding in the pericardial sack surrounding the heart. You’ll often see patients present for FAST exams after traumatic events involving internal bleeding; blunt force trauma, motor vehicle accidents, significant falls, etc.
You’ll also need some modifier smarts to make most FAST exam claims sail through. Follow these rules to foster FAST exam coding success.
The first part of any FAST exam is a limited transthoracic echocardiography (ECG) to check for pericardial fluid, which you should code with 93308 (Echocardiography, transthoracic, real-time with image documentation [2D], includes M-mode recording, when performed, follow-up or limited study).
After the ECG, the physician concludes the FAST exam with a limited abdominal study to check for free fluid in the abdomen. You should code this service with 76705 (Ultrasound, abdominal, real time with image documentation; limited [e.g., single organ, quadrant, follow-up]).
Most FAST exam claims also require that you apply modifier 26 (Professional component) to 93308 and 76705 to show that you’re only coding for the physician’s service, not the equipment he used.
Best bet: Before reporting any FAST exam claims without modifier 26, consult your physician for guidance.