Wiki HELP! Ultrasound global billing

[valerieeanderson]

Hi guys
I really need some help with finding a resource to show my providers. Here's the scenario:

We are a large Urology group practice. We bill globally for ultrasounds. We own the equipment and the facility and employ a tech and radiologist that perform and do a preliminary interp of the ultrasound. The interp is sent to us and then we bill under the ordering urologist. Our urologist have not been doing any kind of note or documentation of the radiologist report. Can we bill these ultrasounds under our Urologist globally WITHOUT their documentation? If so or not, where is the definitive specific documentation that says that?

I say they need to bill under the radiologist but that radiologist is not credentialed. I feel they can bill the TC portion as is but they want to bill globally, wouldn't they need their own interp to do so?

 

[csperoni]

In order to bill the -26 or globally, someone (whether the radiologist or urologist) needs to have an interpretation/report of the ultrasound. The billing should be done by the one signing the report.
If the report is by the radiologist, it should be billed:
#####-26 by radiologist
#####-TC by urologist
If the report is by the urologist, it can be billed global.
https://www.aium.org/resources/guidelines/documentation.pdf

https://www.auanet.org/practice-resources/coding-and-reimbursement/coding-resources-and-information/ultrasound-documentation-requirements

EDIT after reading an answer in a duplicate post:
Medicare will permit the urologist to bill globally, but the radiologist must be enrolled in Medicare.