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Thread: CPT code 76645 and 76942

  1. #1

    Default CPT code 76645 and 76942

    Hello,

    A physician performs an ultrasound of the breast to identify the area of concern. Once identified he preps the skin and then makes a small surgical incision. Under ultrasound guidance he places the biopsy device. Can both 76645 and 76942 be billed?.

    Thank you for your help.

    Monika

  2. #2
    Join Date
    Apr 2007
    Location
    atlanta GA
    Posts
    98

    Default Ultrasound

    Only 76942............

    Quote Originally Posted by Monika Liddle View Post
    Hello,

    A physician performs an ultrasound of the breast to identify the area of concern. Once identified he preps the skin and then makes a small surgical incision. Under ultrasound guidance he places the biopsy device. Can both 76645 and 76942 be billed?.

    Thank you for your help.

    Monika

  3. #3
    Join Date
    Apr 2007
    Location
    Columbus GA
    Posts
    571

    Default

    I feel that since they are separate exams and not bundled according to the CCI edits that you can charge for the 76645 also.
    Jackie, CPC

    Choose a job you love, and you will never have to work a day in your life. ~Confucius~

  4. #4
    Join Date
    Apr 2007
    Location
    Alexandria, LA
    Posts
    517

    Default

    Quote Originally Posted by Monika Liddle View Post
    Hello,

    A physician performs an ultrasound of the breast to identify the area of concern. Once identified he preps the skin and then makes a small surgical incision. Under ultrasound guidance he places the biopsy device. Can both 76645 and 76942 be billed?.

    Thank you for your help.

    Monika
    localizing the area of concern is part of guidance. Do not code 76645 unless it is a separate diagnostic ultrasound that then prompted the need for a biopsy.

  5. #5

    Default Ultrasound

    I feel I should not be billing the 76645 because the pt had a previous US and that is the reason the pt is havign the biopsy. One of my physicians states he was told at a conference that he could and should be billing both. Does anyone have anything in writing indicating we should or should not bill the 76645.

    Thanks for your help.

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