Radiology Coding Alert

Question: Our radiologist often reads the films for intraoperative carotid ultrasounds, but we do not perform the ultrasounds. In fact, a hospital-employed technologist performs the ultrasound in the operating room (our physician is not present), and we read the films the next day. Should we report the ultrasound code with modifier -52? We have the same question regarding intraoperative angiograms.

Washington, D.C. Subscriber

Answer: You should append modifier -26 (Professional component) to either CPT 93880 (Duplex scan of extracranial arteries; complete bilateral study) or CPT 93882 (... unilateral or limited study) for the carotid ultrasound, depending on whether the radiologist interpreted a bilateral or unilateral study.

Modifier -26 tells the payer that another practitioner performed the ultrasound's technical portion, and that your radiologist performed only the interpretation.

If, however, the radiologist interprets an intraoperative angiogram report for a study at which the radiologist was not present to supervise, you should append both modifiers -26 and -52 (Reduced services) to the appropriate code. Whereas modifier -26 tells the payer that your physician does not own the equipment or employ the technologist, modifier -52 demonstrates that he did not perform the entire described radiological supervision and interpretation code (for example, the physician did provide the interpretation but not the supervision).