ED Coding and Reimbursement Alert

Question: Our ED physician recently performed a limited aortic ultrasound using the hospitals equipment. Notes indicate that the physician conducted the ultrasound and interpreted the results. Are we allowed to report this service?

Alabama Subscriber

Answer: Yes, you can report the ultrasound with 76775 (Ultrasound, retroperitoneal [e.g., renal, aorta, nodes], real time with image documentation; limited).

Append modifier 26 (Professional component) to 76775 to show that you are only coding for your physician's services.

Also: To keep the claim compliant, be sure you have the following on record:

" A formal report on the ultrasound encounter. This must be equivalent to a report that a specialist in the field (meaning a radiologist) might provide.

" An image of the ultrasound copy in retrievable format-- either a printed copy of some of the ultrasound views, or a file on a computer disc or hard drive that you can easily recall if necessary.

You dont want to be without these two vital pieces of information if the payer flags the claim for any reason.

--Reader Questions and You Be the Coder reviewed by Michael A. Granovsky, MD, CPC, FACEP, president of MRSI, an ED coding and billing company in Woburn, Mass.