kwiegscpc
Guest
Is anyone else having trouble with the 55700(Prostate needle biopsy), 76942(Us guidance needle biopsy) and the 76872(echo prostate transrectal). We are getting denials on the 76872, even with modifier. Any suggestions?
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Wiki Biopsy denials
- Thread starter kwiegscpc
- Start date
Kelly_Mayumi
Expert
- Messages
- 385
- Best answers
- 0
I have not seen or heard anything about the US being denied. The AUA website has forms online to help with appeals.
zaidaaquino
Guru
What modifier are you using and on what code are you appending it to? Which insurance is denying? Although all three codes are billable, some insurances have their own guidelines which require a modifier -59 on 76872. Let me know.
valeriealbert
Contributor
We have expierienced this too. We are appealing with the AUA letter of medical necessity and a copy of the CCI bundling edit showing they should not deny with 59 mod.Is anyone else having trouble with the 55700(Prostate needle biopsy), 76942(Us guidance needle biopsy) and the 76872(echo prostate transrectal). We are getting denials on the 76872, even with modifier. Any suggestions?
RobynS.
Guest
55700
76942 26
76942 26
RobynS.
Guest
Sorry, didnt finish coding.......but it should be
55700
76942 26
76872 26 59
55700
76942 26
76872 26 59
RobynS.
Guest
MOD. 26 Depending on place of service