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Wiki Need ultrasound clarification

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myrna brown

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ONE OF MY PHYSICIANS WHO HAS SEVERAL INFERTILITY OFFICES IN THE US HAS BEEN BILLING 76830 ( ULTRASOUND, TRANSVAGINAL) WITH 76831-59 (SALINE INFUSION SONOHYSTEROGRAPHY (SIS). WILL THE CARRIERS TREAT THIS A TWO DICTINCT SERVICES OR WILL THEY BE BUNDLED?
MYRNA BROWN
halbrown@cox.net
 
76830 is bundled into 76831 in CCI. You can unbundle with 59 modifier if you can support that they are:
Distinct Procedural Service: Under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-E/M services performed on the same day. Modifier 59 is used to identify procedures/services, other than E/M services, that are not normally reported together, but are appropriate under the circumstances. Documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same by the same individual.

Louise
 
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