Is CPT 76942 bundled?

Is CPT 76942 bundled?

Effective March 1, 2016, CPT code 76942 (Ultrasonic guidance for needle placement imaging supervision and interpretation) and CPT code 77002 (Fluoroscopic guidance for needle placement) will be bundled as inclusive services when rendered with injections/aspirations of joints, trigger points, tendons or cysts (CPT codes …

Does Medicare pay for 76942?

Under the National Correct Coding Initiative, NCCI, which sets CMS payment policy as well as many private payers, one unit of service is allowed for CPT code 76942 in a single patient encounter regardless of the number of needle placements performed.

Can CPT code 76942 be billed twice?

76942 can only be billed once per encounter per CMS.

What is an NCCI modifier?

NCCI-associated modifiers are used to indicate the special circumstances such as when the procedures are performed at different anatomic sites, a separate procedure or repeat clinical diagnostic laboratory test. If an edit allows use of NCCI-associated modifiers, the two procedure codes may be reported together.

Does 76942 require a modifier?

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. This colonoscopy exam includes the ultrasound guidance hence should not be reported separately.

Can 20550 and 76942 be billed together?

Breaking these two CPT codes down, CPT 76942 is an imaging code that lets you visualize what you are injecting. Typically, a plantar fascia injection does not require ultrasound guidance. CPT 20550 is a procedure code. When medically necessary, you can bill both in combination.

Does CPT code 76942 need a modifier?

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.

Does 76942 need a modifier?

What is the 51 modifier for?

Modifier 51 is used to identify the second and subsequent procedures to third party payers. The use of modifier 51 indicates that the multiple procedure discount should be applied to the reimbursement for the code.

How do I find my NCCI edits?

The NCCI Policy Manual, MUEs, and PTP edits are accessed through the NCCI Edits webpage. Links to the PTP Coding Edits, Medically Unlikely Edits, and NCCI manual webpages are provided in the menu on the left side of the NCCI Edits webpage.

How do you bill for ultrasound guided injections?

This service is identified with procedure code, 76942 Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation.

Do you need a modifier for CPT code 76942?

Does CPT code 76942 need a modifier? 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).

What is ultrasonic guidance for needle placement code 76942?

(Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation) Attention is increasing on the descriptor above for code 76942 which specifies that there must be an interpretation for the ultrasound along with the assurance that the ultrasound image is reproducible.

Is there a column 2 code for 76942?

Code 76942 is a column 2 code for 76872, but a modifier is allowed in order to differentiate between the services provided. *Use modifier with code 76942

Do you need CPT code 76942 for nerve block?

Report CPT code 76942 in addition to the code for the nerve block itself Medicare Correct Coding Initiative (CCI) edits do not, at present, bundle the nerve block and ultrasound guidance of the nerve block specific to the procedures listed in this guide. It is recommended to check with each private payer regarding their policies on this service.