Radiology Question for the Week of December 29, 2025

Question:

In regard to last week’s question, should a study be initiated but not completed, what modifier would we report with the code?

Answer:

If the study is initiated but not completed (e.g., patient refusal, inability to tolerate imaging, or equipment failure), report the intended CPT code with:

• Modifier 52 (Reduced Services) for a partially performed study, or
• Modifier 53 (Discontinued Procedure) when stopped due to patient circumstances.

Some commercial payers may not accept modifier 52. In these cases, report the HCPCS radiopharmaceutical code plus an IV administration code, as appropriate:

• 96365 – IV push for a single substance or drug when the radiopharmaceutical is administered as a push/bolus.
• 96374 – IV infusion for a single substance or drug when the radiopharmaceutical is administered via a continuous infusion.

Always report the HCPCS radiopharmaceutical supply code, even if a separate payment is not made.
Accurate reporting ensures compliance with OPPS charge data and supports future reimbursement calculations.