Urology Coding Alert
Watch Whether 76872 Overrides 76942
Question: I’ve recently returned to urology coding after spending several years in another specialty. In years past, we were able to bill 76872 and 76942 on the same claim. Is that still allowed? Oklahoma Subscriber Answer: When you check Correct Coding Initiative (CCI) edits, 76942 (Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation) is classified a Column 2 code for 76872 (Ultrasound, transrectal). Therefore, you should bill one or the other, not both, at the same time. Also, it would not be accurate to unbundle this edit to receive reimbursements for both. If you’re filing a claim, your best option is to report only 76872 since it has higher relative value units (RVUs) than 76942 (3.62 RVUs for code 76872 versus 1.61 RVUs for code 76942).
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