Abdominal Ultrasound (complete)

What it is

Ultrasound sends high-frequency sound into the body and listens for the echoes coming back off the boundaries between tissues. Because the images are live, the sonographer can watch organs move and can chase a finding around in real time. What makes this study complete rather than limited is its scope: it is a systematic survey in which the liver, gallbladder, bile ducts, pancreas, spleen, both kidneys and the major abdominal vessels are each imaged and recorded, whether or not any of them was the reason for the order. That matters clinically — an unexplained abnormal liver test is a question about several organs at once — and it is also what separates this code from the limited version, which documents only a focused area.

Why it is done

• To find the cause of upper abdominal pain, particularly pain that suggests the gallbladder
• To look for gallstones, a blocked bile duct, or a swollen gallbladder wall
• To investigate abnormal liver blood tests, jaundice, or an enlarged organ felt on examination
• To assess the kidneys, the spleen, or the diameter of the abdominal aorta
• To characterize a mass seen on another test, or to check fluid in the abdomen

What to expect

Most facilities ask patients not to eat for several hours beforehand, because a gallbladder that has emptied after a meal contracts and becomes hard to assess, and because gas in the bowel scatters sound. Warm gel is spread on the abdomen and the sonographer presses a handheld probe across it, often firmly, and asks for held breaths and rolls onto one side or the other to get around ribs and gas. It is painless in itself, although pressing over a sore gallbladder can hurt — and whether it does is information the doctor wants. The scan generally runs 20 to 45 minutes. A radiologist reads the recorded images afterward.

Questions worth asking

• Was a complete or a limited study ordered? The complete survey is a higher-priced code, and a price quoted for one does not cover the other.
• If Doppler flow imaging of the liver or the vessels is added, is that billed as an additional study on top of this one?
• Will there be a separate professional charge for the radiologist's interpretation alongside the facility's charge for performing the scan?
• Is a hospital outpatient department or an independent imaging center doing this, and what does each charge for the same complete exam?