Wiki 76700 billed with 76775-XU

[RaeToll]

I have a facility claim denial for CPT code 76775-XU due to invalid modifier. I'm aware procedure code 76776 is considered to be a component of the comprehensive code 76700. However, I'm questioning if CPT 76775 should in fact be billed separately based on documentation. There are TWO SEPARATE reports. The first report completed at 11:08 for ultrasound imaging of the abdominal aorta including color and spectral doppler evaluation. The second report completed at 11:11 for ultrasound imaging of the complete abdomen including color doppler evaluation fo the main portal vein with representative images.

The first report list findings of the aorta and common iliac arteries.
The second report lists findings for the liver, biliary ducts, pancreas, spleen, kidneys, vasculature and peritoneal cavity.

Should only CPT code 76700 be reported, despite two separate reports with different details?
I appreciate any guidance.

 

[cknorr]

I usually add mod 52 to 76775 in these cases. Someone else may have a better solution?

 

[xXxPARAGONxXx]

I have a facility claim denial for CPT code 76775-XU due to invalid modifier. I'm aware procedure code 76776 is considered to be a component of the comprehensive code 76700. However, I'm questioning if CPT 76775 should in fact be billed separately based on documentation. There are TWO SEPARATE reports. The first report completed at 11:08 for ultrasound imaging of the abdominal aorta including color and spectral doppler evaluation. The second report completed at 11:11 for ultrasound imaging of the complete abdomen including color doppler evaluation fo the main portal vein with representative images.

The first report list findings of the aorta and common iliac arteries.
The second report lists findings for the liver, biliary ducts, pancreas, spleen, kidneys, vasculature and peritoneal cavity.

Should only CPT code 76700 be reported, despite two separate reports with different details?
I appreciate any guidance.

(Why mention 76776 if it was not performed? Typo?)

Code for 76770 and 76775-59 (instead of 76775-XU). This may be just an instance where the payer (non Medicare?) does not accept modifier XU.

If denied, appeal and submit the clinical documentation that justifies the medical necessity of both a complete and a limited retroperitoneal ultrasound on the same date of service. (Once you submit with modifier -59, you should probably expect even that claim to be denied, which is why you should be prepared to justify the medical necessity.)