Neurology & Pain Management Coding Alert
Get Anatomy Right for Chest US
Question: Encounter notes indicate that the provider performed an ultrasound (US) on the patient’s pectoral area including the mediastinum. I reported 76641 x 2 and received a denial; what did I do wrong? Rhode Island Subscriber Answer: Your choice was a bit off based on anatomy. The code you were looking for is 76604 (Ultrasound, chest (includes mediastinum), real time with image documentation). You only need to report the code once because, as the descriptor states, the code includes the chest and the mediastinum. The code you reported, 76641, is specifically for breast US. If you encounter notes in the future that indicate a unilateral breast US, choose from 76641 (Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete) and 76642 (… limited), as appropriate.
Related Articles
Neurology & Pain Management Coding Alert
- ICD-10 Coding:
Take Mystery Out of Osteoarthritis Dx Coding
Remember, osteoarthritis can affect many body areas. Patients often report to the PM specialist to [...] - Modifier Madness:
Use Q6 on Locum Tenens/FTC Claims
Did you know Medicare no longer uses locum tenens in its literature? Physicians in busy [...] - ICD-10 Coding:
Don’t Use Gut Instincts for Abdominal Pain Dx
Here’s why you should scrutinize for symptom, age, severity, and site. One of the more [...] - You Be the Coder:
Get Anatomy Right for Chest US
Question: Encounter notes indicate that the provider performed an ultrasound (US) on the patient’s pectoral area [...] - Reader Questions:
Choose Puncture Code After Injection Answer
Question: What code should I report when my provider performs a cisternal C1-C2 puncture? Michigan Subscriber [...] - Reader Questions:
Use Decision Tree to Strengthen Headache Dx
Question: Some of our coders are having trouble getting the ICD-10 codes for our headache patients [...] - Reader Questions:
Know What Brain Mapping Code Covers
Question: What does functional brain mapping CPT® code 96020 cover? And how do I report an [...] - Reader Questions:
Use This Dx for Roussy-Levy Syndrome
Question: Encounter notes indicate that the provider performed a level-three evaluation and management (E/M) service for [...] - Reader Questions:
Monitoring Makes EEG Code Choice Clear
Question: Notes indicate that the provider performed a 10-hour electroencephalogram (EEG). There is no mention of [...]
