Radiology Coding Alert

Question: I have a report for a transplanted kidney ultrasound, but it doesn't describe duplex Doppler. Would it be appropriate to append modifier 52 to 76776 in this case? North Dakota Subscriber Answer: CPT guidelines instruct you to report 76775 (Ultrasound, retroperitoneal [e.g., renal, aorta, nodes], real-time with image documentation; limited) for the situation you describe. You should not report 76776-52 (Ultrasound, transplanted kidney, real-time and duplex Doppler with image documentation; Reduced services) for this service. You're unlikely to see a transplanted kidney ultrasound (US) without duplex Doppler often. The physician typically wants to evaluate any anatomic abnormalities as well as blood flow to detect any complications. Term tip: Duplex Doppler is "an ultrasonic scanning procedure for characterizing the pattern and direction of blood flow in arteries or veins with the production of real-time images integrating B-mode twodimensional vascular structure, Doppler spectral analysis, and color flow Doppler imaging," CPT states [...]