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Leorah Posted Wed 15th of November, 2017 16:47:02 PM
Our office billed code 76377 after a diagnostic cerebral angiogram because of a diagnosis of a cerebral aneurysm. Code 76377 was denied by Medicare because a cerebral aneurysm-I67.1 according to Medicare is not a covered condition. Please tell me where I can find a list of acceptable ICD codes that we would be allowed to use for 76377. Thank you
SuperCoder Answered Thu 16th of November, 2017 01:48:53 AM

Hi,

CPT 76377 is incorrect code for billing diagnostic cerebral angiogram.

It’s tough to code the diagnostic cerebral angiogram without more information (where did the catheter stop, which vessels were imaged/interpreted), but compare the documentation to the code range 36221-36228.

Thanks

Leorah Posted Wed 06th of December, 2017 01:28:20 AM
I am very confused about your answer because when 76377 was first introduced as a usable code. It stated in the 2013 CPT book "Report 76376 and 76377 for 3D rendering when performed in conjunction with 36221-36228". It specifically says that 76377 can be used when performing a diagnostic cerebral angiogram and catheterization codes are used.
SuperCoder Answered Thu 07th of December, 2017 01:33:21 AM

Hi,

You are right if we are using 3D rendering with 36221-36228 series, we need to report 76376-76337 code. You did not mentioned earlier that you are usinig 3D rendering thats why answer was contradictory.

I checked the LCD for few states for Dx I67.1 with 76377, this Dx does not support the medical necessity, This is the reason you got a denial from medicare. kindly check the LCD policy of your state and contractor andyou will find a list of Dx that are allowed with code 76376or 76377 that supports medical necessity.

Thanks

Leorah Posted Sun 10th of December, 2017 14:30:33 PM
Could you please direct me to where and how I can look this up with your software? Thank you
SuperCoder Answered Mon 11th of December, 2017 02:57:52 AM

Hi.

You can check the LCD policy in LCD lookup in compliance tool. You can also check directly on CMS site.

Please find the attachment for CMS site

>https://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=34337&ver=9&SearchType=Advanced&CoverageSelection=Local&ArticleType=SAD|Ed&PolicyType=Both&s=All&CptHcpcsCode=76377&kq=true&bc=IAAAACAAAAAAAA==&:

 

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