yolanda Posted Wed 29th of April, 2020 15:51:19 PM
We have been using 46260, Hemorrhoidectomy internal and external hemorrhoids, 2 or more columns/groups with Ultrasound guidance 76998, and we aren't being paid by the insurance carriers for the 76998. 0249T has been deleted, and there are no other Ultrasound guidance codes other then the 76998 code to use besides 76872, however 76872 is just an Transrectal Ultrasound.
My question is this, the new code 46948, can it be billed for both internal and external hemorrhoids because it includes ultrasound guidance or is it appropriate to bill 46260 with 76872 instead of 46260 with 76998? I would be looking for a response by tomorrow as its very urgent.
SuperCoder Answered Thu 30th of April, 2020 15:14:02 PM
Thank you for your question.
It is appropriate to bill 46260, Hemorrhoidectomy internal and external hemorrhoids, 2 or more columns/groups with 76998 (Ultrasonic guidance, intraoperative). There is no NCCI edit conflict between these two codes. However, since this code is intraoperative, that is it is billed in hospital settings only and not in office visit, so we will bill this code (76998) with modifier 26 (professional component). Feel free to ask for any further query.
76942 Or 76998 Depends on Place of Service.