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Market Access & Reimbursement

Echosens has a collection of Market Access Tools to help healthcare providers make informed decisions regarding the use its products. If you have questions regarding Reimbursement, or need more information, please contact the Echosens Market Access Hotline.  Dedicated professionals are available to help answer your questions.

> FibroScan® Coverage Alert, click to read

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Echosens Market Access Hotline

Hours: Monday through Friday, 9am-5pm EST
Email: fibroscan@echosens.com
Telephone: 866-905-4837 (option 4)

Market Access Guide for Care Management Utilizing Elastography

This document addresses coding, coverage, and payment for FibroScan®, and services commonly performed as part of the FibroScan® patient journey, when performed in the physician’s office and the hospital outpatient department.

This document focuses on Medicare program policies. Medicare Payments listed in this guide are the 2026 national average payments. Non-Medicare payers may have different guidelines for coding, coverage, and reimbursement for the services listed in this guide.
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CPT 76981: The Correct Code for FibroScan®

Selecting the right billing code from the outset is crucial for ensuring prompt, successful reimbursement and avoiding costly denials and compliance pitfalls. Despite growing market confusion fueled by misinformation about imaging requirements, CPT 76981 accurately and compliantly describe the work performed during a FibroScan®.

Understanding Ultrasound Elastography Requirements for CPT 76981

At the core of recent market confusion is one myth — that only B-mode imaging qualifies for 76981. Let’s set the record straight. CPT 76981 requires ultrasound image guidance and does not differentiate between 1D imaging and 2D imaging (B-mode). The requirement is image-based guidance to locate the region of interest for assessment of organ (liver) stiffness. This is not the code for a diagnostic ultrasound of the liver.

FibroScan®’s integrated TM-mode/1D ultrasound offers what’s required — image guidance to reliably locate central liver tissue and assess the stiffness of the organ. The result is a simple, all-in-one workflow with an integrated probe that provides image guidance, shear wave generation, and elastography measurements.

CPT 76981 is not a code for a full diagnostic ultrasound. It describes elastography with image guidance. Using 76981 for FibroScan® requires documentation of the exam, and interpretation and archival of images, which is more than what is required for 91200. If you do the work for 76981, payers expect you will bill for it, which is why payer coverage policies list both codes in their policies. If you perform a full diagnostic liver ultrasound, not just elastography, codes 76700 or 76705 would be billed in addition to, not instead of, 76981. And like 76981, this additional code(s) will require a description of the exam, interpretation, and archival of the images separate from the documentation for 76981.

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Documenting to Support FibroScan® Billing Code 76981

Thorough documentation and accurate ultrasound elastography billing are the most important factors for ensuring payment, defending against payer audits, and meeting compliance requirements for FibroScan® reimbursement with CPT 76981.

For each FibroScan® exam billed, the CPT 76981 documentation requirements must be met. That means your medical record must show that:

  • Imaging was used and interpreted
  • Images were archived in the patient record
  • Findings were interpreted and documented
  • Clinical indication/diagnosis was linked to the ICD-10 code for billing

 

Begin by reviewing the documentation template in our coding and billing guide for FibroScan®, which offers a strong starting point for compliant records.

Preventing and Resolving Issues with CPT 76981 Claims

Insurance companies require documentation that your device and documentation meet their coverage criteria. FibroScan® has established universal coverage with payers thanks to its clinical validation in more than 6,500 peer-reviewed publications and inclusion in hundreds of U.S. and International practice guidelines.

Always refer to the latest policy documents from your region’s major insurers to confirm ongoing coverage and keep links or copies handy for payer inquiries. Most claim denials (less than 1% of all claims submitted) are due to improper ICD-10 codes or lack of clinical documentation. Payers accept 76981 as an appropriate CPT code for FibroScan® but only if the exam documentation supports it. If you’re not saving the report to the EHR, describing the exam and its results, and reviewing/interpreting the images, you should not be coding with 76981.

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Pre-Billing Checklist for CPT 76981

Before submitting any claim for FibroScan® using 76981, here’s a pre-billing checklist you can use to help reduce risk and prevent denials:

  • Exam performed with ultrasound elastography imaging.
  • Images archived in patient record.
  • Written interpretation completed.
  • Documentation includes imaging component description.
  • Diagnosis code supports medical necessity.
  • Proper modifier applied (if applicable).

How to Prevent Claim Denials

Denials happen, even when payers have explicit coverage policies and clear coding guidelines. Most result from incomplete documentation, incorrect modifiers, missing image archival or interpretation, unsupported diagnosis codes, or staff unfamiliarity with billing requirements.

You can prevent these issues by:

  • Using standardized documentation templates.
  • Ensuring the FibroScan® report is saved to the patient’s medical record.
  • Submitting detailed clinical documentation of the exam, including imaging and interpretation (if requested by payer).
  • Sharing up-to-date payer policy or coverage bulletins that support FibroScan® and CPT code 76981 if asked.
  • Completing a pre-billing checklist before claim submission.

Reach out to Echosens Market Access for Help With Billing FibroScan® 76981

For more on CPT 76981 compliance, documentation templates and ICD-10 coding, please contact the Echosens Market Access Hotline.
Reach out online for more information on using CPT 76981 with confidence when billing for FibroScan®.

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Frequently Asked Questions Regarding Ultrasound Elastography Coding and Reimbursement

Have questions about billing FibroScan® with CPT 76981? Here are answers to some of the most common questions providers and billing teams ask.

Why is CPT 76981 appropriate for FibroScan®? chevron

CPT 76981 describes ultrasound elastography that uses ultrasound imaging/guidance and requires provide interpret the images as part of the exam. FibroScan® performs ultrasound elastography with imaging and provides liver images on its report which can be interpreted.

Don’t I need a regular (B-mode) ultrasound as well? chevron

No. FibroScan®’s imaging technology meets the guidance requirements for CPT 76981. There are no specific modes of ultrasound listed in the American College of Radiology’s Ultrasound Coding Guide. The FibroScan® report includes both the images of the liver and the elastograms. If 76981 required a specific mode of ultrasound, it would be listed in the description of the code. And remember, CPT 76981 describes the use of image guidance for the assessment of organ stiffness, it does not describe a full diagnostic ultrasound of the liver.

Will payers accept 76981 for FibroScan®? chevron

Yes, when claims are submitted with full documentation of the imaging process, image archival, interpretation, and clinical necessity.

Between CPT 76981 vs. 91200, isn’t code 91200 simpler? chevron

91200 describes liver elastography without imaging. The work requirement for this code is less than what is required for 76981. There is no requirement to interpret images, and the report does not need to be saved. For providers that do not wish to interpret the liver images or create notes in the medical record describing the FibroScan® exam, 91200 may be a more appropriate code. To provide the best care for the patient, providers should be reviewing/interpreting images from the report and documenting the exam and it’s results in the medical record. When this work is completed, providers should bill for 76981 as it most accurately describes the work performed.

Remember, CPT codes describe the work that is performed. When you perform the work associated with 76981 using a FibroScan® device, you should bill appropriately for it.

Is the imaging component optional? chevron

No. The use of imaging is a key part of the code’s definition. Your documentation must demonstrate that imaging guidance was used during the elastography exam.

Can I bill for 76981 without saving images? chevron

No, archiving images is not optional. It is a compliance requirement for 76981. Payers or auditors may request proof that imaging supported the exam and verify that images were interpreted.

Save the FibroScan® report, including representative images, in the EHR. Or, if paper-based, scan and upload into the record management system. Then retain all records per your organizational, state and payer guidelines — typically a minimum of five to seven years.