Wiki NCCI Edits???? 76536 & 99214 with same dx

[mmelendez]

Please advise if a thyroid ultrasound can be billed with a visit.... My Dr wants me to use the same diagnosis for both services. I believe this is not correct as per NCCI edits.

 

[mitchellde]

You can have the same diagnosis you need the 25 modifier and the documentation to support that they are significant and separately identifiable. If the ultrasound was scheduled in advance then you cannot charge the visit. If the ultrasound was decided after the visit then it is possible to bill for both again depending on the documentation.

 

[dclark7]

There is no NCCI edit for these two codes.

 

[mmelendez]

Thank you!