Wiki 64450 and 76942

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No prohibition per NCCI

There is no CMS edit between the codes. However, every time I use 76942 the insurance company always denies it stating that it's for biopsies due to the CPT description of the code. One of the many examples given in the CPT description is a biopsy and insurance companies seen to focus on that one and totally ignore the other examples given.

So what I am saying is that be prepared to send an appeal and make sure you point out the other uses of the code.
 
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