Wiki 76000-When would this code

efuhrmann

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When would this code be used appropriately? The rad techs are forever using it instead of 77002 and I don't review all the denials and the reimbursement for the procedure, e.g. fluoro guided hip injection, is less than it could be. I would like to delete the option of using 76000, however I need to keep it if there is a use for it.
 
76000 is listed as a separate procedure in CPT. Typically, these types of procedures should not be billed when the service is performed in conjunction with a more comprehensive procedure. Per CPT Assistant, 76000 is considered to be an inclusive component of any other formal radiologic procedures and should not be reported separately. Depending on carrier requirements, modifier 59, may be appended to code 76000 to indicate that a distinct or independent service was performed.

Although it is not specifically stated in the "endoscopy" code descriptors (eg, laparoscopy, hysteroscopy, thoracoscopy, arthroscopy, GI endoscopy, esophagoscopy, colonoscopy, laryngoscopy, bronchoscopy, and cystoscopy), fluoroscopy, when utilized, is inherent in all endoscopic procedures. Therefore, it is not appropriate to additionally report code 76000 for endoscopic procedures. You can find many references to this in the NCCI manuals...

http://www.cms.hhs.gov/NationalCorrectCodInitEd/01_overview.asp#TopOfPage

Fluoroscopy is also considered inherent to many radiological supervision and interpretation (RS&I) services, such as those provided in support of gastrointestinal examinations, arthrography, myelography, cholecystography, venography, arteriography, and cystography. Code 76000 or 76001 would not be coded separately in addition to the applicable RS&I code.

Does this help some?
 
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