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Wiki Ultrasound for diagnostic

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SSweetland

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Local Chapter Officer
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Beloit, WI
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Can you tell me if a physician uses ultrasound for diagnostic and then decides based on findings to inject the joint that now includes the ultrasound is acceptable to charge the diagnostic ultrsound and 20611 or will the insurance deny the diagnostic ultrasound?
 
Medicare has paid both an ultrasound and a guided injection charge. I say give it a try, then trouble shoot what the denial is implying. I haven't heard from anyone it's considered included in the other procedure.
They are separate. We used to bill (and it was allowed) a 76882 or 76881 with a 20610 and a 76942.
2 of my doctors are the only certified in CT for ultrasound, and they use it a lot. It has been a great tool to insure injections are effective, and for quicker diagnosis.
That being said insurance companies are making it really tough to figure out what it permitted and when. Even with in the same company they are inconsistent with what they approve and deny and why.
Some insurance companies are paying, some are only paying sometimes, and some not at all. I'm trying to figure out modifiers and dx changes. I think all of the insurance companies haven't really figured out how they will handle it.
Many insurances will no longer cover a 20611 for hyalgan or euflexxa.
 
thank you so much, I am glad you told me that you are having issues also with different insurance companies.
 
apsullivan said:
Medicare has paid both an ultrasound and a guided injection charge. I say give it a try, then trouble shoot what the denial is implying. I haven't heard from anyone it's considered included in the other procedure.
They are separate. We used to bill (and it was allowed) a 76882 or 76881 with a 20610 and a 76942.
2 of my doctors are the only certified in CT for ultrasound, and they use it a lot. It has been a great tool to insure injections are effective, and for quicker diagnosis.
That being said insurance companies are making it really tough to figure out what it permitted and when. Even with in the same company they are inconsistent with what they approve and deny and why.
Some insurance companies are paying, some are only paying sometimes, and some not at all. I'm trying to figure out modifiers and dx changes. I think all of the insurance companies haven't really figured out how they will handle it.
Many insurances will no longer cover a 20611 for hyalgan or euflexxa.
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What about billing 62350 with 76942? UHC has been denying these codes when billed together. Is it safe to say a 26 modifier can be used?
 
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