tci ED Coding & Reimbursement Alert - 2011 Issue 1

Reader Question: Mind New CPT Sets for US Service

Question: I have a denial in front of me that is quite puzzling. Our ED physician performed a complete nonvascular ultrasound of a trauma patient's right leg. The US included image documentation; I reported 76880 and received a denial. What should I do for re-submission?Answer: The code you submitted was deleted in CPT 2011, so the denial was most likely due to that fact. Go back and check the claim; if the service date was in 2011, then 76880 (Ultrasound, extremity, nonvascular, real time with image documentation) was the wrong code.If the insurer denied the claim because you...

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