Does CPT code 76942 require a modifier?

Does CPT code 76942 require a modifier?

Neither modifier TC nor modifier 26 are required for billing these services globally. The coder or biller can bill this procedure (CPT 76942) without modifiers, and the benefits of both components (technical and professional) may be included in the single line item.

What modifier do I use for 76942?

While coding for physicians the medical coders can append 26 modifier with CPT code 76942 for diagnostic ultrasound. The 70000 series codes are from radiology chapter and hence the ultrasonic/ultrasound guidance codes can be reported with 26 modifier. Ultrasound guidance are used for performing percutaneous surgeries.

Is 76942 a payable code?

A: There is no AMA CPT coding restriction to reporting CPT code 76942 (Ultrasonic guidance for needle placement [eg, biopsy, aspiration, injection, localization device], imaging supervision and interpretation) when ultrasound guidance is medically necessary to accurately place the needle for the injection.

How many times can you bill 76942?

76942 can only be billed once per encounter per CMS.

How do I bill my carpal tunnel shot?

CPT code 20526 is to be used for therapeutic carpal tunnel syndrome injections. Use ICD-9 code 354.0. CPT codes 20550 and 20551 must not be used for joint injections.

What situation is modifier 59 most commonly used for?

Modifier 59 is used to identify procedures/services, other than E/M services, that are not normally reported together, but are appropriate under the circumstances.

How do you bill multiple tendon sheath injections?

Per the CPT guidelines, if multiple injections are performed into the same tendon sheath/origin, then codes 20550 or 20551 should only be reported only once. If there are multiple injections into multiple sites, then you may report codes 20550 or 20551 once per injection.

What is the CPT code for cubital tunnel injection?

The injection would be equivalent to CPT 20526 (carpal tunnel injection), but performed into the cubital tunnel. We have been using an unlisted code from the nervous system (64999), the ASC has been reporting an unlisted code from the musculoskeletal system (24999).

What is XS modifier used for?

Modifier XS Separate structure – A service that is distinct because it was performed on a separate organ/structure. Modifier XU Unusual non-overlapping service – The use of a service that is distinct because it does not overlap usual components of the main service.

Why is the coding department coding a-59 modifier with 76942?

HELP We bill for anesthesia providers, and have come across a pattern with the coding department, coding a -59 modifier with the 76942. Their reasoning is that the machine is owned by the anesthesia provider, and because they are billing “global” and using the -59.

What does CPT 76942 mean?

The CPT 76942 is a unit and it stands only for a certain kind of situation which has to be authentic in nature for the billing to be valid. In this case, one needs to mention that the particular CPT 76942 refers to the ultrasonic guidance which is often required for needle placement in processes like biopsy or even injection.

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.

What is the difference between CPT modifier 59 and 76?

Under most circumstances, CPT modifier 59 is not appropriate for use with E/M or surgical procedure codes. One exception is multiple facet joint injections. These procedures are not staged, so CPT modifier 58 is not appropriate. These are not considered ‘repeat procedures,’ so CPT modifier 76 is not appropriate.