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The CPT® Code 76776 refers to an ultrasound procedure specifically designed for the evaluation of a transplanted kidney. This ultrasound study employs real-time imaging and duplex Doppler technology, which allows for comprehensive assessment and documentation of the kidney's condition. The procedure can be performed during the early perioperative period or as part of routine follow-up care. The primary purpose of this ultrasound is to evaluate renal function and monitor for potential complications that may arise post-transplantation. The ultrasound consists of two main components: gray scale imaging and Doppler imaging. Gray scale imaging provides a detailed view of the kidney's structure without assessing motion, while Doppler imaging visualizes blood flow within the kidney. These two imaging modalities are displayed simultaneously on the same screen, allowing for a real-time representation that aids in both documentation and interpretation by the radiologist. Typically, a transplanted kidney is located in the extraperitoneal space of the right or left iliac fossa, which facilitates optimal visualization during the ultrasound examination. A thorough review of the patient's medical history, including the specific renal transplant procedure performed, is essential to ensure accurate documentation of any findings, whether they are normal or abnormal. During the ultrasound, the perinephric space is scrutinized for any fluid collections, which may include urine, blood, lymph, or pus. Common complications in the immediate postoperative period, particularly within the first two weeks, include urinomas and hematomas. Lymphoceles, which are fluid collections that can occur later, typically manifest between four to eight weeks after surgery. The renal parenchyma is also evaluated for various signs that may indicate decreased renal function or potential rejection of the transplanted organ. These signs include cortical thickening or enlargement, changes in echogenicity, loss of corticomedullary differentiation, prominent pyramids, and thickened collecting systems. Additionally, the urinary collecting system is assessed for any leaks, obstructions, or calculi. Finally, the vascular structures are examined for conditions such as renal artery occlusion, renal vein thrombosis, or stenosis, which can significantly impact the health of the transplanted kidney.
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The ultrasound procedure coded as CPT® 76776 is indicated for the following conditions and situations:
The ultrasound procedure coded as CPT® 76776 involves several key steps to ensure a comprehensive evaluation of the transplanted kidney:
After the completion of the ultrasound procedure, the patient may be monitored for any immediate reactions, although the procedure is generally non-invasive and well-tolerated. The results of the ultrasound are documented and interpreted by a radiologist, who will provide a report detailing any findings related to the transplanted kidney's structure, function, and vascular status. Follow-up care may be recommended based on the findings, and any necessary interventions or additional imaging studies may be scheduled to address identified complications or concerns. It is important for healthcare providers to communicate the results to the patient and discuss any further steps required for ongoing monitoring and management of the transplanted kidney.
| Short Descr | US EXAM K TRANSPL W/DOPPLER | Medium Descr | US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN | Long Descr | Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 4 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic imaging procedures apply... | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 88 - | APC Status Indicator | Codes That May Be Paid Through a Composite APC | ASC Payment Indicator | Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS relative payment weight. | Type of Service (TOS) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I3F - Echography/ultrasonography - other | MUE | 2 | CCS Clinical Classification | 195 - Diagnostic ultrasound of urinary tract |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | GC | This service has been performed in part by a resident under the direction of a teaching physician | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | RT | Right side (used to identify procedures performed on the right side of the body) | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | LT | Left side (used to identify procedures performed on the left side of the body) | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | CR | Catastrophe/disaster related | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | ET | Emergency services | GA | Waiver of liability statement issued as required by payer policy, individual case | GQ | Via asynchronous telecommunications system | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | HH | Integrated mental health/substance abuse program | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q5 | Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2007-01-01 | Added | First appearance in code book in 2007. |
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