ED Coding and Reimbursement Alert

Question: I have a denial in front of me that is quite puzzling. Our ED physician performed a complete nonvascular ultrasound of a trauma patient's right leg. The US included image documentation; I reported 76880 and received a denial. What should I do for re-submission?

Answer: The code you submitted was deleted in CPT 2011, so the denial was most likely due to that fact. Go back and check the claim; if the service date was in 2011, then 76880 (Ultrasound, extremity, nonvascular, real time with image documentation) was the wrong code.

If the insurer denied the claim because you used 76880, then re-submit the claim using 76881 (Ultrasound, extremity, nonvascular, real-time with image documentation; complete).