Summary & Overview
CPT 76978: Microbubble Contrast-Enhanced Ultrasound for Lesion and Perfusion Assessment
CPT code 76978 represents targeted microbubble contrast–enhanced ultrasound (CEUS) with injection of lipid- or protein-coated gas-filled microspheres to assess suspicious lesions or evaluate organ perfusion, most commonly in the liver and kidneys. This procedure matters nationally as CEUS expands clinical use for lesion characterization and real-time vascular assessment, offering a radiation-free alternative to CT or MRI in select cases. Payer coverage and coding recognition affect access to CEUS across settings, influencing diagnostic pathways for oncology and hepatology.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of how the code is defined, the clinical contexts in which the service is used, and what to expect in terms of typical sites of service. The publication provides benchmark information and policy updates where available, clarifies clinical indications for lesion and perfusion assessment, and outlines documentation elements relevant to billing CEUS. Data not available in the input for specific modifiers, taxonomies, and ICD-10 pairings is noted where applicable.
Billing Code Overview
CPT code 76978 describes the targeted administration of an intravenous ultrasound contrast agent made of lipid- or protein-coated microbubbles with a gas core, followed by a focused contrast-enhanced ultrasound (CEUS) examination. The procedure is used to assess lesions suspicious for malignancy or to evaluate organ blood flow, commonly in the liver and kidneys.
Service type: Contrast-enhanced diagnostic ultrasound examination with microbubble contrast injection
Typical site of service: Hospital outpatient imaging departments, ambulatory imaging centers, and specialized ultrasound suites
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a history of colorectal cancer surveillance presents for characterization of a focal liver lesion identified on recent CT. The ordering oncologist requests targeted contrast-enhanced ultrasound with intravenous microbubble agent to evaluate lesion vascularity and to help distinguish benign from malignant features prior to biopsy or treatment planning. The patient arrives at an outpatient radiology suite. A registered nurse or technologist confirms identity, reviews allergies, and establishes IV access. The interpreting radiologist (or credentialed sonographer under physician supervision) performs baseline grayscale and Doppler ultrasound of the liver, administers the lipid- or protein-coated gas-core microbubble contrast agent per manufacturer and institutional protocols, and acquires targeted contrast-enhanced sonographic images of the lesion during arterial, portal venous, and late phases. The radiologist documents real-time enhancement patterns, compares to prior imaging, and issues a report describing lesion enhancement characteristics and recommendations for further management. Typical site of service: outpatient radiology department, hospital outpatient imaging center, or specialized ultrasound suite. Procedure type: targeted microbubble contrast-enhanced ultrasound examination with intravenous administration of contrast material.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the interpreting physician's portion separate from technical services. |