Medicare Compliance & Reimbursement

Diagnostic imaging services are under increased payer scrutiny. More and more EDs are using ultrasound services for diagnosis, but ED coders may not be fully up to speed on reporting these quick and non-invasive visualizations. Take a close look at the advice that follows to get an easy-to-apply view of the requirements for successful ultrasound billing. Getting started: For diagnostic ultrasound codes, look in the radiology section of the CPT® book using codes 76506 through 76999, instructs Michael A. Granovsky, MD, FACEP, CPC, President of LogixHealth, a medical coding and billing company in Bedford MA . The codes are organized by anatomic area with greater specificity of organs or structures visualized grouped by specific study. Check These 4 Overarching CPT® Requirements The preamble to the diagnostic ultrasound section of CPT® lists these 4 requirements: 1. Medical necessity -- The medical record documentation must indicate why the test was medically necessary. Payers [...]