Wiki CPT 20551/20552 with 76942

codiologist

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Hi all,

My employer had been getting denials from a specific insurance company when billing 20551 or 20552 with 76942 U/S guidance (s&I) when performed. Denial says we can't bill these codes together per CCI edits, no modifier to add and we need to write off the 76942. My office has been writing the 76942 off per this insurance company. I disagree with this and think this insurance company should be paying this 76942 as well. I'm pretty new to this company I work for so other employees tend to think I don't know what I'm doing. I've been a CPC for 10 years and reviewed the 2016 AMA cpt book and it does say this is okay to bill together if in fact U/S guidance is performed, which it has. Unless there has been another update to CCI edits for 2016 that I don't know about. Can anyone confirm or deny this coding combo???

Thanks for any input,
Codiologist
 
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