ICD-10-PCS Billable Code

BG42ZZZ

Ultrasonography Adrenal Glands, Bilateral to None with None, None Approach

Procedural Specifications

Clinical Axis Detail Definition
SectionB Imaging
Body SystemG Endocrine System
Operation4 Ultrasonography
Body Part2 Adrenal Glands, Bilateral
ApproachZ None
DeviceZ None
QualifierZ None

Operation Definition

Real time display of images of anatomy or flow information developed from the capture of reflected and attenuated high frequency sound waves

Procedure Overview

This family covers ultrasound exams of endocrine glands, overwhelmingly the thyroid and parathyroid glands, since these sit close to the skin surface where sound waves travel well. A handheld probe sends high-frequency sound into the neck and captures the echoes bouncing back from tissue, building a real-time picture without any radiation involved.

Thyroid ultrasound is typically ordered after a lump is felt on physical exam, when blood tests suggest a thyroid problem, or to monitor a known nodule over time. It is also the standard tool for guiding a needle biopsy when a nodule needs tissue sampling, and for evaluating suspected parathyroid enlargement in patients with abnormal calcium levels. Because it is quick, radiation-free, and can be repeated often, it is usually the first imaging step before more advanced studies are considered.

Coders assigning from this family need the report to confirm that a gland, and not just the general neck soft tissue, was the target structure. When ultrasound is used to guide a biopsy or aspiration procedure, that guidance function is typically captured separately from the diagnostic imaging itself, and conflating the two is a common source of miscoding.

Anatomy & Axis Detail

Adrenal Glands, Bilateral

Bilateral adrenal ultrasound evaluates both glands in a single encounter, most useful as an initial, radiation-free look at suspected adrenal enlargement, such as in congenital adrenal hyperplasia in infants or when biochemical testing suggests bilateral hyperfunction without a clear lateralizing lesion. Because the right gland is more readily visualized through the liver while the left often requires a splenic or posterior approach, technique and image quality commonly differ between sides within the same study. Ultrasound is generally more effective at detecting an enlarged or mass-replaced gland than at confirming a normal-sized gland is truly disease-free, so equivocal findings often prompt follow-up CT or MRI. Documentation should note the approach used for each side and any asymmetry in visualization or findings.

Coding & Documentation

Confirm the report names the thyroid or parathyroid specifically rather than describing a general neck soft tissue survey, and check whether the study served a diagnostic purpose versus procedural guidance for a biopsy, since those are coded differently.

Commonly Confused With

This family is sometimes confused with soft tissue ultrasound of the neck performed for unrelated masses or lymph node evaluation. The key distinction is whether the endocrine gland itself, rather than surrounding lymph nodes or muscle, was the documented subject of the exam.

Procedural Guidance & FAQs

Coding Accuracy

Is BG42ZZZ a billable procedure?

Yes, BG42ZZZ is a complete, 7-character procedural specification that is acceptable for hospital claim reimbursement.

Technical Axis

What approach is used for BG42ZZZ?

This procedure utilizes the None approach, mapping to the 5th character in the PCS axis.

Metadata Tags

adrenal bilateral ultrasonography