EM Coding Alert

Question: Our group practice has a radiology department that performs several ultrasounds ordered by other group providers every week. The radiologists provide the interpretations for the ultrasounds. Later, the patients return, and the ordering provider reviews the test results with the patient. Can our practice report the ultrasounds if the ordering provider reports an evaluation and management (E/M) code?

Arizona Subscriber

Answer: Yes, if your practice performs and interprets the ultrasound, you may report the code for that service.

Example: An established patient presents to their primary care physician (PCP) at your group practice complaining of abdominal pain. The PCP orders a complete abdominal ultrasound, which is performed in the in-house radiology department. The radiologist provides a written interpretation of the ultrasound. Two days later, the patient returns to receive the results of the test.

The radiologist should assign 76700 (Ultrasound, abdominal, real time with image documentation; complete) to report the complete abdominal ultrasound. The PCP should be careful not to count independent interpretation of the ultrasound when calculating the medical decision making for their evaluation and management (E/M) code.