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Wiki 76000 - hand surgeon

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mconnolly

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I bill for a hand surgeon and he uses fluorscopy instead of an xray. He was billing 76000. I was told by another coder that we cannot use that code if he doesn't own or use a c-arm, which he does not. We were told to use 76496, but we are not getting paid for this code by any ins even with notes. Can anyone suggest what we can use for this procedure. Thanks.
 
According to this article, if your provider doesn't own the equipment then you should be appending modifier 26 to CPT 76000. I use 76000-26 whenever my providers document that they use fluoro or c-arm during the procedure. As far as I know, these are getting paid without issue. The main thing I would watch for is if there is a CCI edit between 76000 and your procedure. If there is, then the imaging is included in that code and is not separately reportable.
 
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