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Using codes 75894 and 76377

Leorah Posted Wed 01st of March, 2017 14:57:37 PM
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 Answered Thu 02nd of March, 2017 08:28:15 AM

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 Thu 02nd of March, 2017 16:05:12 PM
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 Answered Fri 03rd of March, 2017 09:12:22 AM

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

SuperCoder Answered Fri 03rd of March, 2017 09:12:23 AM
Hi, our team is working on it and will get back soon.
SuperCoder Answered Mon 06th of March, 2017 08:41:07 AM

Hi,

The above information can be found on Super coder.

 

SuperCoder Answered Mon 06th of March, 2017 08:41:07 AM
Hi, our team is working on it and will get back soon.
Leorah Posted Tue 07th of March, 2017 13:10:51 PM
Where can I find this in supercoder? I have a subscription. Could you please help me find the answer for my appeal?
SuperCoder Answered Thu 09th of March, 2017 08:24:22 AM

Hi,

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

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