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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 distills the coding experience of MedLearns national consulting practice, combined with Medicare coverage policies and billing guidelines. Highlights:
- CPT codes, billing tips and coding guidance related to biopsy, aspiration, needle localization and vascular-access procedures
- Eliminates the confusion associated with coding for non-invasive peripheral duplex and Doppler vascular procedures, including ankle brachial index (ABI) assessments
- Explains the difference between complete and limited abdominal/retroperitoneal scans
- Detailed information related to coding for echocardiography (fetal and non-fetal) in the hospital and physician office setting
- Case studies addressing many common concerns pertaining to the application of CPT codes, plus a chapter devoted to answering many frequently asked questions
- Updated APC payments and physician fee schedules
- Appendices containing detailed information related to the ordering of additional diagnostic tests by the radiologist
- NEW FOR 2012:
- 2012 changes to non-invasive vascular codes
- Documentation examples for both obstetrical and non-OB procedures
- New at-a-glance tables with codes, modifiers, payments and descriptions
Findings from MedLearn consulting experts
MedLearn publications address your real-world challenges and concerns, including the following examples shared by our consulting experts.
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 2012. 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 dont understand the differences between limited and complete duplex exams. Weve 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.
Difficulty with ABI coding Coding for ABI procedures continues to be problematic for technologists and billers in hospitals and physician offices. The 2012 edition of our Ultrasound Coder book fully explains the intent of these codes and how they should be used, thus helping facilities avoid regulatory compliance issues.
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 radiologists documentation doesnt match whats being billed, or the hospital enters its charges before receiving the physicians 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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