Wiki Ultrasound

stephmescher

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Dyersvile, IA
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A patient presents for a Kidney and Bladder ultrasound, when performing the ultrasound the tech finds issues with the ovaries and these are imaged and reported. The diagnosis for the Kidney and Bladder is of urinary tract pathology, so I am able to code the 76770. Am I able to add the limited pelvic for the images of the ovaries in addition to the 76770? Same would be with a male and the prostate is imaged.
Thanks
Steph
 
Yes, you could charge for the limited pelvis but I would only do this if I had an order for it. I code for Out-patient hospital.
 
Was there an order for the ovaries or prostate to be imaged? If not, I would not recommend coding for the additional images. The facility performing the test should do their best to obtain a new order from the ordering provider prior to the additional images being performed. See below from Chapter 15 of the Medicare Benefit Policy Manual:

80.6.3 - Rules for Testing Facility to Furnish Additional Tests
(Rev. 80; Issued: 01-11-08; Effective: 01-01-03; Implementation: 11-19-07)
If the testing facility cannot reach the treating physician/practitioner to change the order or obtain a new order and documents this in the medical record, then the testing facility may furnish the additional diagnostic test if all of the following criteria apply:
• The testing center performs the diagnostic test ordered by the treating physician/practitioner;
• The interpreting physician at the testing facility determines and documents that, because of the abnormal result of the diagnostic test performed, an additional diagnostic test is medically necessary;
• Delaying the performance of the additional diagnostic test would have an adverse effect on the care of the beneficiary;
• The result of the test is communicated to and is used by the treating physician/practitioner in the treatment of the beneficiary; and
• The interpreting physician at the testing facility documents in his/her report why additional testing was done.

 
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