Diagnostic Ultra Sound

jkluck

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Help!! Please advise. Title or procedure. Do you think that the following note substantiates a Diagnostic US? Trans rectal US/Guidance for a needle biopsy/needle biopsy. Technique - "Trans rectal US was subsequently performed. A lidocaine periprostatic block was performed under US guidance. 12 biopsies of the prostate were subsequently performed in sextant fashion with ultrasound guidance. The patient tolerated this well." Thanks.....Jacque
 

emcee101

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Not a chance...

nope, not at all, no way. In order to bill for a diagnostic US the physician would have to document the diagnostic results of the ultrasound, including but not limited to - prostate density, volume and measurements, seminal vesicles, median lobe size/protrusion, hypoechoic areas, etc.

All your doctor documented was the US for guidance, and that code (76942) along with the bx code is all that you should bill for. Anything else is a very clear case of upcoding fraud.
 
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Is there additional information you can post? The quote begins with the US being done "subsequently"... subsequently to what? What else was happening before and/or after? Is this just the summary of the procedure?
 

jkluck

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Default Diagnostic Ultra Sound

Thanks for your help.........
nope, not at all, no way. In order to bill for a diagnostic US the physician would have to document the diagnostic results of the ultrasound, including but not limited to - prostate density, volume and measurements, seminal vesicles, median lobe size/protrusion, hypoechoic areas, etc.

All your doctor documented was the US for guidance, and that code (76942) along with the bx code is all that you should bill for. Anything else is a very clear case of upcoding fraud.
 
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