PVR - can we bill 51798 if the patient is not established

kburow5446@gmail.com

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We will get requests from a patients primary care provider to perform an ultrasound PVR on a patient of theirs. These patients are not established with us. They come in and under the direct supervision of a physician a nurse will performed the PVR (51798).
Management is concerned that although we are performing this and our provider (MD) is in the office, because they are not one of our patients, we can not bill for the PVR. I can not find anything stating we are not allowed to bill. Can we bill for a PVR if done on someone who is not our patient?

Any advice or direction would be great appreciated.

Thank you
Kelly, COC
 

thomas7331

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You can bill this for other providers' patients. It's a diagnostic test (the code is classified as a technical component only) so you just need to make sure you have a valid order from the provider who requested it with a diagnosis that supports medical necessity.
 
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