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There is no CCI edit for 76856 bundled into 99204. As gyn oncology, we do a TON of sonograms in the office. As long as it's justified, I would recommend adding modifiers.
99204-25
76856-59
That is what we do anytime a visit and sonogram are performed on the same date. We don't get bundling denials, but we do get denials from some insurances for requiring authorization or referral for sonograms.