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 in its "Noninvasive Vascular Diagnostic Studies" guidelines.

Remember: If you do report a transplanted kidney US with duplex Doppler, 76776 includes the duplex scan, so you should not report 93975 (Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study) or 93976 (... limited study) separately.