Wiki Medicare denial for US Breast

[Mcsalazar00]

All of my claim are getting denied by Medicare. I've billed them out as 76642 RT and 76642 LT, denied code CO151. Can someone help.

 

[iowagirl77]

Since there is an MUE of 1 for 76642, I would recommend billing it out as 76642-50.

 

[Mcsalazar00]

Since there is an MUE of 1 for 76642, I would recommend billing it out as 76642-50.

We tried billing it with Mod 50 and it got denied as well.

 

[xXxPARAGONxXx]

Sounds like the patient already had a breast ultrasound performed within the year (maybe not at your facility).

 

[shall@ftmc.com]

did you leave the units as 1 when you billed it with a modifier 50?

 

[iowagirl77]

All of my claim are getting denied by Medicare. I've billed them out as 76642 RT and 76642 LT, denied code CO151. Can someone help.

Do you need a 26 or TC modifier?