Who is telling you that you can use the ultrasound report as documentation of an E&M? An ultrasound report is just that a report. It can be used to bill the professional portion of the ultrasound. An E&M requires the physician to physically see the patient and perform at least two of the three elements(for established patients). I would refer to the guidelines as stated in the CPT book. If you could use the report to bill an E&M, radiologists would be able to bill an E&M for every xray that they performed!
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