Radiology Question for the Week of December 13, 2021

Question:

If we are doing an ultrasound of the abdomen, ovaries, or scrotum and we use Doppler over the same areas do we charge a Doppler complete (93975) or limited (93976) in addition to the body part US code?

Answer:

Are you doing a duplex scan (grayscale of the vascular structures, color flow doppler, and spectral analysis), or only a color doppler? If you are doing true duplex scans, and they are ordered and medically necessary, it would depend on what is imaged. You can bill with the regular 70000 ultrasound code, but you will need modifier 59 or XU on one of the codes. For a complete, you need to evaluate both the arterial and venous blood flow to the organ(s) as well as the major vessels providing blood flow to the organ. For paired organs such as the ovaries or the kidneys, you have to completely evaluate both of the paired organs for 93975. If you evaluate only one of the paired organs (such as only the right ovary, or right kidney), then you have to report a limited 93976. You have to determine each report to see what was documented to determine if 93975 or 93976 is to be reported when appropriate. If all you are doing is turning on the color doppler to see if there is blood flow, there is no additional code.

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