Coding for duplex scan or color Doppler ultrasound of abdomen, ovaries or scrotum

Q.

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

A.

Are you actually performing 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 charge for the duplex procedure with the typical 76xxx ultrasound CPT code, but you will need to assign modifier 59 or XU on one of the codes.

For a complete duplex procedure (CPT 93975), you need to evaluate both the arterial and venous blood flow to and from the organ(s) as well as the major vessels providing blood flow to and from the organ. For paired organs such as the ovaries or the kidneys, you have to completely evaluate both of the paired organs to support assignment of CPT code 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 duplex procedure using CPT code 93976.

You have to review each report to see what was documented to determine if CPT code 93975 or CPT code 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 as this does not constitute a duplex (limited or complete) procedure.