BobLoblaw78

2+ Year Member
Jan 15, 2018
172
168
Status
  1. Attending Physician
I have been informed by our billers that charging for ultrasound requires too much documentation to continue billing. I know that ultrasound billing has been threatened for awhile, but I still thought they were allowing it. Has there been changes? Have you ran into this issue and/or found a solution? I was told the reading and documentation of the ultrasound had to be consistent with a radiology read. I have always put "ultrasound was used to advance xxx needle, while visualizing xxx nerve, xxx artery/vein and surrounding structures. Vascular puncture avoided and local anesthetic spread was visualized and acceptable".....etc.

Are you doing this, less or more? I would appreciate tips, information or help prior to my sit-down to make it as productive as possible. I could just let it go, but don't believe that it is the best thing for the hospital. It sounds like an overly conservative biller to me. Thanks!

PS- I did not find any threads covering this
 

DM27

10+ Year Member
May 7, 2008
479
459
Status
  1. Attending Physician
We had stepped back on it a bit mainly due to an IT/attending issue. We noticed that many attendings were not saving images from the procedures they did, and those that were saving them were having issues with them properly uploading to our PACS-type system. What we were told by the billing person in our department, and I have not verified if this is true, is that if we were ever "audited" regarding this billing we would need to be able to produce the images saved for each patient this was billed for. Since it turned out that this would not be the case there were plans to scale back significantly on it. I am not part of the group within the department who worked on this so I don't know the ultimate outcome, but this is what I gleaned from a few conversations about it.
 
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AdmiralChz

10+ Year Member
Sep 8, 2008
3,785
3,654
Mid-Atlantic
Status
  1. Attending Physician
We print a picture tag it to what procedure it was used for once it is scanned into the chart. We have been doing it for years and if the printer is broken (often here at Level 1) we upload it via Haiku.

Nearly all of our companies have been asking for the pictures and we have been sending along appropriately. We don’t get many denials, but then again it isn’t too much of a bump. None are reimbursing anymore for ultrasound-guided a-lines at least around here.
 
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pjl

10+ Year Member
Oct 29, 2006
1,111
869
Status
  1. Attending Physician
We bill, your partners/self/billers who are not documenting sufficiently are costing you a lot of money (depending on volume).

I write something about it in my note, and use haiku on my phone to put the picture in the chart. Picture is showing needle, nerve, and anything else that is pertinent. Prior to the haiku app it took a lot longer and was a pain to add the pics to the chart.

Too much documentation required should be an easy process fix. Find out if it is too much that physicians are missing due to lack of process, or too much work for them to go through current process.
Then find a way to incentivize the physician charting if needed. Lots of the time just education is enough. Being paid on production fixes most of these issues .
 
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Justice4all

5+ Year Member
Feb 19, 2014
208
159
Status
  1. Attending Physician
US image is captured and transmitted to PACS at my current shop . But in residency, it was printed out by the techs at a community site and we used the epic Haiku at the main institution.
 
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