nrood
Networker
Hello fellow coders,
I have some questions regarding POCUS in an Endocrinologist office and I hope someone can provide their expertise/experience.
Our provider does a quick, focused ultrasound at the bedside (we own equipment). Sometimes she will find, for example, a rather large nodule but will want to still send the patient to the hospital for a more thorough ultrasound/mapping. Other times, she is doing a quick look, but not concerned with what she is seeing, so no further eval is warranted. Either way, she is currently not billing for thyroid ultrasounds.
I do not see any specific documentation requirements associated with 76536 in the CPT book and there isn't a "limited" study code. Can the 76536 be used for a quick look or does the provider have to do a thorough ultrasound like with TIRADS? Our provider feels that the ultrasound she does is not as thorough as what radiology would be doing. Would a modifier be warranted/required?
Additionally, in anyone's experience, if you bill the study in the office and send the patient to the hospital for further study, have you or the hospital encountered any denials for frequency?
Does anyone have any references for further guidance?
I greatly appreciate any help!
I have some questions regarding POCUS in an Endocrinologist office and I hope someone can provide their expertise/experience.
Our provider does a quick, focused ultrasound at the bedside (we own equipment). Sometimes she will find, for example, a rather large nodule but will want to still send the patient to the hospital for a more thorough ultrasound/mapping. Other times, she is doing a quick look, but not concerned with what she is seeing, so no further eval is warranted. Either way, she is currently not billing for thyroid ultrasounds.
I do not see any specific documentation requirements associated with 76536 in the CPT book and there isn't a "limited" study code. Can the 76536 be used for a quick look or does the provider have to do a thorough ultrasound like with TIRADS? Our provider feels that the ultrasound she does is not as thorough as what radiology would be doing. Would a modifier be warranted/required?
Additionally, in anyone's experience, if you bill the study in the office and send the patient to the hospital for further study, have you or the hospital encountered any denials for frequency?
Does anyone have any references for further guidance?
I greatly appreciate any help!
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