Our consulting expertise at your fingertips
Are you mystified by the coding and billing requirements for diagnostic ultrasound procedures? Fear not, our Ultrasound Coder book will guide you through the intricacies! This timely resource details the coding experience of MedLearn's national consulting practice, combined with Medicare coverage policies and billing guidelines. Highlights:
- Guidance related to biopsy, aspiration, needle localization, vascular-access and non-invasive peripheral vascular procedures
- Content is divided into diagnostic ultrasound, ultrasound guidance procedures, echocardiography (fetal and non-fetal), non-invasive vascular diagnostic studies and intravascular ultrasound sections, each with CPT codes and billing tips
- Eliminates the confusion associated with coding for non-invasive peripheral duplex and Doppler vascular procedures
- Differentiates between complete and limited abdominal/retroperitoneal scans
- Details the difference between complete and limited abdominal/retroperitoneal scans
- Detailed information related to codes for echocardiography, including all-inclusive echocardiogram with color-flow and Doppler, all-inclusive stress echo and stress echo with contrast
- Appendices containing detailed information related to the ordering of additional diagnostic tests by the radiologist
- NEW FOR 2011:
- Comprehensive coverage of 2011 code changes, including two new codes for complete and limited scans of the shoulder and ankle joint and two revised codes for non-invasive imaging intended to address incorrect coding and billing for ankle/brachial index (ABI) testing
- Several new case studies that address common concerns pertaining to the application of CPT codes
- New chapter providing answers to many frequently asked question
Findings from MedLearn consulting experts
MedLearn consulting experts speak from their real-world experiences regarding the potential benefits of Ultrasound Coder to healthcare organizations:
RAC and OIG alert! "In 2009 providers were required to start using bundled codes for echocardiography (cardiac ultrasound), making these claims a prime target for scrutiny by the Recovery Audit Contractor (RAC) program in 2011. Compounding compliance challenges for providers, the Office of Inspector General (OIG) is taking a hard look at billing for ultrasound. This comes after the OIG determined that one in five ultrasound claims nationwide had questionable elements. Our assessment: Accurate coding and clean claims for ultrasound services have never been more crucial."
Under-coding or over-coding for scans - "Many hospitals and physician practices routinely under-code or over-code for duplex ultrasound scans, because coders don't understand the differences between limited and complete duplex exams. We've observed several instances of facilities inaccurately charging for duplex scans. Ultrasound Coder can help providers reduce exposure by consistently distinguishing between limited and complete scans and how to properly code them."
Confusion over codes - "Under-reporting, and sometimes over-reporting, commonly result from not knowing how to code correctly for non-invasive vascular ultrasound procedures. Our book provides clear guidance through these widely misunderstood areas of coding, which in turn can help strengthen regulatory compliance while preserving the appropriate reimbursement. One problem we've observed is incorrect coding and billing for ABI, a high-volume procedure at many hospitals and vascular surgery practices. For 2011, providers need to be aware of the two revised codes for ABI and how to appropriately report each one."
Reporting conflicts - "A lack of coordination between radiologists and hospital ultrasound departments can lead to the two sides reporting different codes for the same procedure. This often occurs when the radiologist's documentation doesn't match what's being billed, or the hospital enters its charges before receiving the physician's dictation. In these instances, one or both providers risk claim denials by third-party payers - an outcome that can be prevented by following the instruction in Ultrasound Coder."
CPT is a registered trademark of the American Medical Association
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