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does cpt code 76942 need a modifier

by Donavon Herzog Published 3 years ago Updated 2 years ago

CPT code 76942 should not be reported and modifier 59 should not be used if the ultrasonic guidance is for needle placement for the laparoscopic liver tumor ablation procedure. Code 76942 may be reported with modifier 59 if the ultrasonic guidance for needle placement is unrelated to the laparoscopic liver tumor ablation procedure.

Do not use CPT code 76942 for vascular procedures; separate ultrasound guidance code 76937 is used for these procedures. Do not use any modifiers like RT, LT, 59, 51 etc with CPT code 76942.Apr 15, 2020

Full Answer

Can CPT code 76942 be used more than once?

A: From a CPT coding perspective code From a CPT coding perspective, code 76942 should be should be reported per distinct lesion that requires separate needle p,p lacement. Therefore, if several passes are made into two separate lesions in the same organ (ie, two lesions in same breast), then code 76942 would be reported twice.

What modifier is 76942 on The MPFS?

Answer: In relation to the Medicare physician fee schedule (MPFS), the modifier you're most likely to use with 76942 (Ultrasonic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], imaging supervision and interpretation) is modifier 26 (Professional component). Click to see full answer.

What does CPT 76942 mean for ASCs Chapter 14?

Below is from the Medicare claims processing manual for ASCs Chapter 14. Medicare or Medicare Advantage plans consider CPT 76942 to have a N1 status indicator in ASCs. N1 rrepresents services that are considered packaged into the surgical procedure and no separate payment is made.

Are CPT codes 76942 and 77022 considered incidental to 20552?

Note: The services represented by CPT codes 76942 and 77022 are considered incidental to injection procedure codes 20550, 20552 and 20553, and will not be separately reimbursed when submitted with these procedure codes. Modifier 59 will not override this bundling edit.

Is CPT 76942 bundled?

Correct Coding Solutions, Medicare contractor for the National Correct Coding Initiative (NCCI), has issued their final decision to bundle CPT code 76942 Ultrasonic guidance for needle placement paired with CPT codes describing diagnostic ultrasound procedures (specific for urology, CPT code 76872 Ultrasound, ...Dec 7, 2016

Can CPT code 76942 be billed twice?

76942 can only be billed once per encounter per CMS.Nov 6, 2017

What CPT codes can be billed with 76942?

CPT Code 76942, Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection and localization device), imaging supervision and interpretation, is an appropriate code for certain procedures when performed. In these cases, the primary injection code is billed in addition to 76942 for ultrasound guidance.May 30, 2017

Can 20611 and 76942 be billed together?

For example, the parenthetical note following CPT code 20611 states: “(Do not report 20610, 20611 in conjunction with 27370, 76942)”. Thus, CPT codes 27370 and 76942 should not be reported with arthrocentesis procedures described by CPT codes 20610 and 20611.

Can 20553 and 76942 be billed together?

The answer is NO, it is not billable as bilateral. Because you are billing on the number of muscles or trigger points. There is no left and right on this procedure.Feb 20, 2018

Can CPT code 76942 be billed with 76872?

Although AMA Guidelines state it is appropriate to bill CPT codes 76942, 77002, 77012 or 77021 if imaging is performed with 55700, NCCI lists 76942 as a column 2 code for 76872. You should not bill 76942 when 76872 is performed during the same session.Jul 26, 2021

What is the CPT code for arterial line placement?

Arterial Catheter (CPT code 36620) - Placement of a small catheter, usually in the radial artery, and connection of the catheter to electronic equipment allow for continuous monitoring of a patient's blood pressure or when other means of measuring blood pressure are unreliable or unattainable.

What is the CPT code for radical neck partial laryngectomy for CA?

Total laryngectomy procedures were categorized by one of two CPT codes: 31,360 and 31,365 – total laryngectomy without or with radical neck dissection, respectively.

What is the difference between fluoroscopy and ultrasound?

Purpose: Ultrasound-guided spinal injections are less common than fluoroscopy-guided injections. Although unable to penetrate bones, ultrasound guidance has a number of advantages including convenience and reduced exposure to ionizing radiation.

Does CPT 20551 include ultrasound guidance?

Is it correct CPT coding to report the ultrasound guidance CPT code 76942 when the physician performs tendon injections or a carpal tunnel injection? The CPT code descriptions for 20550, 20551, and 20526 do not include the terms “with ultrasound guidance, with permanent recording and reporting” in their definitions.Dec 30, 2021

Does CPT code 64415 need a modifier?

Based upon Correct Coding Initiative (CCI),the allowance of CPT code 64415 is bundled to allowance of code 29825, a modifier is not allowed to differentiate the service; therefore, the respondent's denial based upon unbundling is supported. As a result reimbursement is not recommended.Jul 18, 2016

What is the CPT code for fluoroscopic guidance for needle placement?

CPT code 77002 describes fluoroscopic guidance for needle placement. Since imaging supervision and interpretation codes include all radiological services necessary to complete the service, it is a misuse of CPT code 77002 to report it separately with CPT code 76930.Sep 26, 2016

What is CPT code 76942?

CPT code 76942 should not be reported and modifier 59 should not be used if the ultrasonic guidance is for needle placement for the laparoscopic liver tumor ablation procedure. Code 76942 may be reported with modifier 59 if the ultrasonic guidance for needle placement is unrelated to the laparoscopic liver tumor ablation procedure.

What is the CPT code for anastomosis?

• has been established and to evaluate the anastomosis may be billed using CPT code 76998. Use of Modifiers#N#• indicating that only the professional service was provided, physicians must be attached to the CPT code for the ultrasound service. Payers will not reimburse physicians for the technical component in the hospital setting.#N#• If reporting a surgical procedure such as a biopsy on the same day E/M service must be “… above and beyond the usual preoperative and postoperative care associated with the procedure that was performed.” (CPT Assistant, May 2003.) Be sure to document in the patient’s record all components of the E&M service.

What is the code for ultrasound guidance?

To report the use of ultrasound to guide injections or aspirations, the suggested code is 76942 – Ultrasonic guidance for needle placement (e.g. biopsy, aspiration, injection, localization device), imaging supervision and interpretation. Report 76942 in addition to the code for the underlying procedure.

What is the code for abdominal ultrasound?

• To bill for the evaluation of a single organ within the abdomen use code 76705 (abdominal ultrasound, limited or follow-up). To bill for Focused Abdominal Sonography for Trauma (FAST) exam, also use code 76705.

What is 20604 in ultrasound?

20604 Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting (Do not report 20600, 20604 in conjunction with 76942) (If fluoroscopic, CT, or MRI guidance is performed, see 77002, 77012, 77021)

Can you report 76942 twice?

Therefore, if several passes are made into two separate lesions in the same organ ( ie, two lesions in same breast), then code 76942 would be reported twice.

Is fluoroscopy necessary for knee surgery?

Fluoroscopy may be medically necessary and allowed if documentation supports that the presentation of the patient’s affected knee on the day of the procedure makes needle insertion problematic. No other imaging modality for the purpose of needle guidance and placement will be covered.”.

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