Ask Dr. Z

We are coding for a vascular surgeon who placed an aorto-bi-iliac endograft to repair a non-ruptured abdominal aortic aneurysm. We are reporting CPT code 34705. The code is, as you know, a combination code that includes "all radiological supervision and interpretation." Since the 2019 CPT manual specifically states that all codes with radiological supervision and interpretation in their code descriptions (whether in the radiology or surgery sections of the manual) require image documentation in the record, we have been clarifying with all of our physicians that images are being stored and are retrievable in the event of a payer audit. In this particular case, though, the physician responded that his radiology S&I images were not stored. This is pretty unusual to my understanding. Would we need to report code 34705 with a reduced service modifier -52 since he cannot produce the radiology S&I imaging in the event of an audit and the rad S&I is included in the code description?