Some pointers:
- You want to know the difference between a “new patient” visit vs a consult (99244/99245). A consult adds about $100 over a new patient eval visit. You can’t bill a consult if it’s a CMS patient (aka Medicare/Medicaid), and you also have to technically communicate back to the referring provider for it to be a consult as well.
- I’m very interested in using the G2211 code but I have no idea how to do it. My practice doesn’t seem to ever bill this code, interestingly.
- Don’t expect MSK ultrasound to be worth the time it takes to break the machine out.
- Likewise, I tend to avoid doing procedures…if I need to tap a joint or something, then yea I’ll absolutely do that…but I’m not one of these rheumatologists who is always trying to do another injection etc. From the point of view of billing, it doesn’t compensate all that much and if you don’t have a well lubed office workflow for doing it, it’s not going to be very efficient. I’d rather just see another patient TBH. And steroid injections are way overused anyway.
in my neck of the woods 9920X and 9924X pay me the same. shrugs
then again I do not see a lot of purely commercial private insuranec. i see mostly managed medicaids and managed medicares
I go G2211 for medicare and managed medicare patients anytime I am evaluating for chronic conditions that are expected to be around ... chronically
for my specialty patients COPD, asthma, IPF, etc... all count
i get an extra $15 or so (subject to copays and deductibles as usual)
go nuts on it for your SLE, RA, fibro patients i guess
of note i tried to bill non Medicare patients but i just get billing error saying this code is not applicable etc... as expected
for primary care side if its the usual DM, HTN, CAD, CKD, etc... im using it if I addressed all those chornic issues on the same visit
i would not be using this if I just addressed some small acute issue in a patient WITH chronic medical issues but i did not address that chronic issue
if the same DM, HTN, CAD, CKD... patient came in for an insect bite... i am just doing some 99212 action on said insect bite and ignoring the G2211 that day.
i've successfully billed for 76882 before in the few situations in which I am looking at someone's knee... osteoarthritis obviously but patient complains of swelling and there must be fluid. i sono'd it and saved images and wrote a quick template report - no effusion
billed successfully under internal medicine and got paid $30 for it
usually if its big enough fluid i would aspirate it. I did get trained in residency for arthrocentesis and did enough to feel good enough to do it if the effusion is large enough (which I would feel comfortable with with point of care U/S to identify said pocket)
I rarely do this maybe twice or thrice a year.... but with a big enough pocket can't possibly miss!
found gout and pseudogout last year. shrugs
the key is get a portable pocket ultrasound. you can't beat the butterfly IQ. it comes with an image portal as well to save your images to.
consider it.
for the record I 76604 everyone who walks my way with dyspnea. (that is US Chest - the same ICU ultrasoudn for lungs use in the outpateint setting for a quick look that sometimes can preclude need for an unnecessary xray of the chest)
