Ob-Gyn Coding Alert

Reader Question:

Ultrasounds Do Not Equal "Incident-To"

Question: If our patient sees the nurse practitioner and undergoes an ultrasound that day, does the physician need to sign the report before we submit the ultrasound to the patient’s insurance?

Colorado Subscriber

Answer: Yes, the physician must complete the interpretation before billing the ultrasound procedure, because this is a basic requirement for billing whether he is billing the global ultrasound code or just the modifier 26 (Professional component) portion for the ultrasound.

If you are allowed to have separate billing by the NP for the visit, that can be billed at the time of visit and is not dependent on the interpretation of the ultrasound.  

Watch out: From you question, however, it is unclear if the NP or the physician is the one who has done the official interpretation. Please keep in mind that interpreting an ultrasound is NOT an incident-to-service. Only the provider who is providing the official interpretation can bill for it.  

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