Wiki UHC denying 93975

[patdow]

We are getting denials from UHC for CPT code 93975. We bill 93975 and 76700 with modifier 59 for an abdominal ultrasound. Recently, UHC has been denying 93975 due to insufficient detail to support all related charges billed.

Is there another CPT code we should use? Such as 93976? Or a modifier?

 

[TThivierge]

Hi Patdow
What is the dx code and problems? CPT 93975 and 76700 are 2 types of ultra sounds...so cannot bill together. Why adding modifier 59? Did the ultrasound scan more than the abdominal area? Let me know because I am curious. Also what is the documentation stating?
Lady T

 

[patdow]

Hi Patdow
What is the dx code and problems? CPT 93975 and 76700 are 2 types of ultra sounds...so cannot bill together. Why adding modifier 59? Did the ultrasound scan more than the abdominal area? Let me know because I am curious. Also what is the documentation stating?
Lady T

The diagnosis is R74.01 elevation of levels of liver transaminase levels. In the past, we never had a problem with insurances paying with this diagnosis code. We always bill those CPT codes together with modifier 59 and have not had an issues. The ultrasound did not scan more than the abdomen.