Wiki How would you code physician Performed 76817 and a sonographer performed 76817 TC Billed Same Day, under Same Provider

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theisel@lakeviewclinic.com

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We have added on-site Ultrasounds to our clinic recently and are trying to determine how to code this scenario properly:
The OB/GYN provider sees a patient for a Transvaginal ultrasound to confirm pregnancy or estimate gestational age (document requirements for 76817) and finds either twin gestation or a concern they want to be evaluated ASAP. Our U/S Schedule has an opening, so they get them on the same day for that appointment.

The Sonographer bills for 76817 TC (the Professional component is billed out by the company that does the interpretation and report).

Since both these claims are for the exact date and the billing provider for both is the provider who saw the patient for the Transvag, I am concerned we will run into issues/denials due to the same service performed the same day.

Should we put a modifier on? We would use the reason for the study as the diagnosis on the 76817 and the findings that required the additional U/S for the 76817 TC.

We are new to this situation, so I appreciate any feedback!
 
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I would confirm there was medical necessity for the patient to require 2 OB sonograms in your office on the same day. If the physician already personally scanned the patient and saw a concern, why was the sono tech needed to also scan the patient? However, only the clinician should make the call about medical necessity.
Also, when you say "sonographer bills for 76817-TC", it is unclear to me who the sonographer works for and which physician's name is on that service. If it is not your employee and a DIFFERENT physician's name is on the claim, -77 may be more appropriate for this situation.
 
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