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Leorah Posted 1 Year(s) ago
Our patient had an embolization procedure and we coded a 61624 and a 75894. In addition, the doctor needed to perform one 76377 for diagnostic purposes to see the complex tiny details of the vessel. I learned from my billing course that coding a 76377 and 75894 should not be a problem. Now I need to appeal an insurance company that is denying my 76377 because they claim that it overlaps the 75894 and should not be coded together. I need documentation from the AMA to prove that as long as the 76377 is for diagnostic purposes and not for guidance, it can be billed together with the 75894. Thanks and how can I find this information on my own if need be?
SuperCoder Posted 1 Year(s) ago

Hi,

CPT code 61624, 75894 and 76377 can be billed together. Application of 26 Modifier to CPT code 76377 and 75894 lead to appropriate reimbursement.

 

 

Leorah Posted 1 Year(s) ago
Thanks for getting back to me. I know that those two codes can be used I was hoping you can help me find documentation from the AMA that expresses that point for my appeal and where can I find documentation in the future for other claims denied by the insurance companies? Thanks
SuperCoder Posted 1 Year(s) ago

Hi, our team is working on it and will get back soon.

SuperCoder Posted 1 Year(s) ago
Hi, our team is working on it and will get back soon.
SuperCoder Posted 1 Year(s) ago

Hi,

The above information can be found on Super coder.

 

SuperCoder Posted 1 Year(s) ago
Hi, our team is working on it and will get back soon.
Leorah Posted 1 Year(s) ago
Where can I find this in supercoder? I have a subscription. Could you please help me find the answer for my appeal?
SuperCoder Posted 1 Year(s) ago

Hi,

No definitve link (by CMS) can be found. However, the CCI edits do not show conflict , hence the code can be billed together.

Posted by Leorah, 1 Year(s). There are 7 posts. The latest reply is from SuperCoder.

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