Wiki 76856 and 93975

[kathleenl]

Good Afternoon,
We are finding a lot of rejections from United Healthcare in particular on this coding combination. They state that 76856 is included in 93975 and this is confusing me a lot! Can anyone shed some light on this for me - particuraly why/how one is included in the other - the description of the doppler does not state anything about a sonogram....

ANY help / guidance is appreciated.

Thanks!
Kathleen

 

[akonyk]

76856 & 93975 billing together

I think I would bill the 76856 (pelvic US) 1st and the 93975 with 59 modifier. I also would use different dx for the duplex.
The 76856 is the US and duplex scan is of venous and arterial doppler.
Hope it helps a little.