CPT code 91200: Liver elastography, mechanically induced shear wave

Learn more about CPT code 91200, its documentation requirements, and billing guidelines for proper and accurate use and billing.

Use Code

What is the 91200 CPT code?

CPT code 91200 is described as "liver elastography, technically induced shear wave (e.g. vibration), without imaging, with interpretation and report" and is used to report the noninvasive liver elastography procedure to assess liver stiffness to diagnose and manage liver conditions such as hepatitis B, hepatitis C, etc.

CPT code 91200 documentation requirements

For thorough and accurate documentation, the following key elements must be included in the patient's medical records:

Medical necessity (e.g., chronic hepatitis B or C, nonalcoholic fatty liver disease or NAFLD)
Technique used
Details of the procedure performed
Stiffness value in kilopascals (kPa)
Interpretation of fibrosis staging
Provider signature and report date

CPT code 91200 billing guidelines

To ensure appropriate reimbursement for the liver elastography service and compliance for CPT code 91200, one must follow the billing guidelines below:

Report once per session, even if multiple readings are obtained.
Appropriate modifiers are used or appended depending on the circumstances. Examples of possible modifiers are modifier -25 for when a significant, separately identifiable evaluation and management (E/M) service is performed by the same healthcare provider, and modifier -76, indicates that the repeat of liver elastography is done by the same physician on the same day.
Coverage varies, hence one must verify specific details with specific payer guidelines and with your local Medicare Administrative Contractor (MAC) and consult the Medicare Physician Fee Schedule (MPFS).