Ob-Gyn Coding Alert

Question: I'm trying to bill an ultrasound using 76831/76856. The explanation of benefits (EOB) states, "For processing purposes, the service line has been recoded from the global service to the professional and technical component lines." When I check the sum of the professional and technical payment amounts, the amount is less than the amount in our fee schedule. Is this a violation of our contract and a way to avoid paying the contracted rates? How should I combat this? Florida Subscriber Answer: Contact your carrier and inform them you will appeal each and every claim where you use 76831 (Saline infusion sonohysterography [SIS], including color flow Doppler, when performed) and 76856 (Ultrasound, pelvic [nonobstetric], real time with image documentation; complete). If that doesn't work, notify them they are in violation of your contract, and you will be seeking redress via your state medical association, your state legislators, and the state [...]