Wiki Ultrasound 76880

nmay

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The CPT manual states: Ultrasound, extremity, nonvascular, real time with image documentation. I work for an insurance company and we have a provider that is treating the ankle area only yet has billed 76880 mod 26 times six on the same DOS. In general though, if a provider bills for 2 parts of one leg- say the knee and the ankle- is that considered one unit? Some here think it is "per extremity" and others interpret it as different parts of an extremity can be billed on the same day. If it is "per extremity" then wouldn't the provider only be allowed a maximum of 4 units per day? Thank you.
 
According to the ACR code 76880 should be used to report the upper extremity, lower extremity, axilla and groin only. So I would say the limit would be 6 maximum for one patient. But if they said one particular area it would be one unit. Maybe they made a mistake? 26 sounds kinda silly. Hope that helps!
 
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