Is 76815 "incidental" to 76821?
Date postedApril 30, 2013
Recently, a question was posed on the appropriate way to report coding combination 76821 and 76815. Some insurance companies are denying 76815 “incidental” to 76821. Does using a modifier prevent this coding combination from being denied?
According to Medicare National Correct Coding Edits there are no “bundling” rules with this coding combination and may be reported accordingly during the same session with supporting documentation and clinical indications. Depending on the scrubber software the payer utilizes, you may need to append the Modifier “59” to the Limited Ultrasound.
76821
76815-59
OR
76821-26
76815-26/59