Ob-Gyn Coding Alert

Reader Question:

Professional Component for Ultrasounds

Question: We are beginning to do ob and gyn ultrasounds in our office. All five of our doctors will be ordering the ultrasounds, but only one of the physicians will be reading them. How do we code them to give one physician, who reads the ultrasounds, the professional component for all of them?

Shawn Scarbough
Baptist Health Care Group, Tennessee

Answer: If ultrasounds are performed in your office and they are interpreted there, you can only bill the ultrasound code without a modifier because the unmodified code includes both the technical and professional components of the service. If you want to give the physician who reads them internal credit as far as salary or financial share of the pie is concerned, you may do so after payment is received from the payer. If, on the other hand, you are sending the patient to a radiology department to have the ultrasound performed, but your office doctor is the sole physician billing for the interpretation (which requires a written report), then you can bill the payer for the professional component but only by adding modifier -26 to the ultrasound code. The radiology department will be billing for the technical component.