Reader Question: Some Payers Circumvent CCI

Why This Topic Matters

Understanding this payer issue can help practices anticipate denials, evaluate whether separate imaging services are supportable, and align claims with payer-specific policy for ultrasound studies.

Article Sections

1. Question

   The article opens with a reader inquiry about billing two ultrasound services together and reports a denial concern from the payer.

2. Answer

   The response discusses the general relationship between the two ultrasound services, notes the absence of applicable CCI edits, and explains why some payers may still deny one service.

3. Anatomy covered in the codes

   This section outlines the broad anatomical areas included in the ultrasound studies and explains the overlap that may influence payer review.

4. Check with your payer

   The final guidance emphasizes payer-specific policy considerations and mentions an alternative ultrasound coding approach that may be relevant when claims are reviewed.