Wiki 76881 and 76942 denial

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june616

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Patient was seen for an injection to the thumb for trigger finger dx (727.03). The injection was performed with ultrasound guidance with these codes:

76881
20550
76942
J0702

BCBS denied 76881 and 76942 as "not medically necessary."

I want to appeal this but I don't have enough experience in this area yet. I've tried looking up the LCD for these but no results were found. Can anyone help me and provide info/resources on this topic so I can learn and send an educated appeal?

Thank you!
 
Not sure why 76881 and 76942 were both coded. From your description the MD performed a trigger point injection using ultrasound guidance, only one ultrasound should be used and that should be 76942.26 if interpretation and MD does not own the equipment.
 
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