93976

[Brendacole]

Is anyone billing and getting paid for 93976 CPT code?

 

[LLovett]

Yes, not a lot of them but I just checked and we are getting paid. Are you having problems?

Laura, CPC

 

[Brendacole]

yes, we are getting denials. we only started with this code this year. Am I correct in the info I have researched that it is bundled with a 76700 and if done with a 76856 it needs a -59? I coded pathology for 10 years and am new at radiolgy so I am doing a lot of research here. The rads dictation is also a little vague from the RBMA meeting I attended this past Friday, I think after I point this out to them that will be better.
Thanks for any help you can give me.

Brenda,CPC

 

[tmlbwells]

We usually use it with 76775 and put the 59 modifier on the 76775. As far as I know we're getting paid for it. We do occasionally use it alone, and then with no modifier.

 

[Brendacole]

Does anyone have a report they are willing to share that shows good documentation to support the 93976 code that I can show my rads. They want to see one.

Thanks,
Brenda,CPC

 

[~*Audra*~]

We use the 93976 with 76700, 76705, 76770, 76775, 76870, 76856, and 76857. They always get paid for us. Most of the time it's harder to get the codes I listed here paid, especially with Medicare. On the abdominal and retroperitoneal we put the modifier 59's on.

 

[Brendacole]

Audra,
Do you have a copy of a report that shows good documentation of 76856/93976 that you would be willing to share with me? If so could you block out all pertinent info on report and fax to 864 330 1084? Thanks a million!

 

[sprovis@umc.edu]

Which diagnosis codes do you use because I have gotten edits on 625.8 which is the only code that I have.

diagnosis codes, diagnosis coding

 

[maryt310]

IBC keeps denying our 93976 with and without 59 mod when we bill it with 76859 and 76830 not sure what i am doing wrong help

diagnosis codes, diagnosis coding

 

[csperoni]

IBC keeps denying our 93976 with and without 59 mod when we bill it with 76859 and 76830 not sure what i am doing wrong help

1) I will assume 76859 is a typo for 76856.
2) 93976 is often incorrectly billed when also performing 76830 and/or 76856. It is often used simply to check bloodflow, in which case 93976 should not be billed.
3) If your denial is for medical necessity, most carriers will only pay for 93976 with specific diagnoses. Unless your diagnosis is on their list, it will never be paid.
4) If your denial is for bundling, some carriers set their own policies over and above NCCI edits. You may want to check your carrier policy.
See this thread for a recent discussion about 93976 often misused with other sonograms. https://www.aapc.com/discuss/threads/76830-and-76856-with-doppler.197471/?view=date#post-544326

diagnosis codes, diagnosis coding