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Breast biopsy/us guided code 76942

  1. Default Breast biopsy/us guided code 76942
    Medical Coding Books
    When billing the 76942 each lesion, I coded with quantity ie: (76942 qty 3), Medicare is rejecting. My question is do you bill the first 76942 qty 1, then the second line bill 76942 qty 2 w/modifier 51, or do you bill 76942 seperately for each lesion???

  2. #2
    I thought that you only bill the US guidance 76942 once.?

    Kimberley Tober, CPC
    Franklin, TN

  3. Default
    No, if you look in the cpt assistant april 2005, code 76942 should be reported per distinct lesion that requires separate needle placement per the AMA.

    They were paying, but now are rejecting saying that this code is a single quantity code. So I am going to try and bill each line separate with modifier 51, and or 59 and see what happens.

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