Wiki Can you bill CPT codes 76942 with 76881 or 76882?

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micki127

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Hi,

The physician is under the impression that we cannot bill out 76942 with 76881 or 76882. I have checked the CCI edits and don't see a problem. It is allowed.

Does anyone know if this is not billable and payable together?

Thanks in advance!
 
there probably isn't an edit for those codes because they're so different that they wouldn't be done during the same encounter.

were all of these performed together?? they did a biopsy w/ ultrasound guidance at the same time they did an extremity ultrasound?
 
The provider did a cortisone injection for the shoulder pain. Upon reviewing the MRI the provider disagreed with the MRI and wanted to clarify by doing an Ultra Sound Exam which was determined to be a partial thickness cuff tear. The MRI report only stated minimal fraying.

Do you see a problem with billing out both charges?
 
Medicare guidelines say that 76942 is no longer a valid code. 20611, 20606, and 20604 are to be used instead. You can bill both and get reimbursed. One was used for diagnostic purposes and one was used with the procedure.
I would use separate Dx codes for each.
Sometimes they are denied, but easily corrected with the carrier. (Just as sometimes with 2 large joint injections one is denied as duplicate even though modifiers and Dx codes clearly indicate they are not.)
 
ultrasoud/injection

My boss does an ultrasound before he does an injection. For diagnostic purposes and to see if the injection is warranted. So I bill 76881 and 20610. Would that be correct? Also, If it's a follow up visit say 4 weeks he'll do another to check progress. Would I code 76881 or 76970? If follow up is within 8 weeks I bill 76970. Is this correct?
 
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