76942 (ultrasound guidance) denied with nerve block

[hparra112e@gmail.com]

Hi All,

Ultrasound guidance (76942) is being denied by Oxford when billed with a nerve block code (64413, 64445, etc.). We have tried to appeal saying you need the guidance to ensure precision of the needle however, they are still denying it.

Anyone run into this problem and found a successful way to appeal?

Thanks,
H

 

[danskangel313]

What's the denial reason?

From what I can find, 76942 is only paid if the provider is an "American Institute of Ultrasound in Medicine (AIUM) Accredited General Surgeon" for Oxford.