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Pelvic Ultrasound and Vascular Study

pvang

Networker
Messages
91
Best answers
0
Hi,

Does anyone know if 93976 (Vascular study) is normally billed with 76856 (Pelvic US)? I know that 93976 is mutually exclusive to 76856 but a modifier is allowed in order to differentiate between the services provided. What would I need to look for in the medical records to determine that the vascular study was a distinct procedural service?
Any help is appreciated!

Thanks,

Pa Tang
 

HNISHA

Networker
Messages
77
Best answers
0
Is the report showing medically necessity to perform the second procedure?.

For example. The reason for exam might be different, The procedure might be performed in different sessions or the abnormal result from the primary procedure needs additional attention to do the second procedure.

All the above (medically necessitates) reasons will qualify to bill the CPT with a modifier.

Hope this helps!

Thanks.
 

pvang

Networker
Messages
91
Best answers
0
Thank you for your help. As far as medically necessary, the report states that patient has complaints of pelvic pain on both sides, but more so on the right side. No further documentation of why a vascular study should also be perfomed along with the ultrasound. I'm not sure if the complaint of pelvic pain is enough to be considered as a medical necessity for the vascular study. It seems both of these procedures were done in one session.

Thanks.
 
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