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ultrasound and S&I

  1. #1
    Default ultrasound and S&I
    Medical Coding Books
    Hi, I bill for an endocrinologist who performs ultrasounds of the thyroid 76536. She believes that since she is performing the ultrasound, reading the films, and typing a report, that there is another code which should be billed separately for the interpretation and report. Any ideas what code would be billed in addition to 76536 for the interpretation, or does this 76536 include all? Appreciate your help.

    Debi

  2. Default
    Hi..Debi

    76536 is includes all to code .
    Regards..,
    Nandha CPC

  3. #3
    Default
    Thanks Nandha for your help,
    If you wouldn't mind, I'd like to know your interpretation of this statement which is in CPT, Radiology Guidelines, under Supervision and Interpretation:
    " When a physician performs both the procedure and provides imaging supervision and interpretation, a combination of procedure codes outside the 70000 series and imaging supervision and interpretation codes are to be used." This is what someone pointed out to me, that made me think that maybe I was missing some codes. What do you think? or anyone?

    Thanks again,
    Debi

  4. #4
    Location
    Sioux Falls South Dakota
    Posts
    358
    Default
    Quote Originally Posted by medipro View Post
    Thanks Nandha for your help,
    If you wouldn't mind, I'd like to know your interpretation of this statement which is in CPT, Radiology Guidelines, under Supervision and Interpretation:
    " When a physician performs both the procedure and provides imaging supervision and interpretation, a combination of procedure codes outside the 70000 series and imaging supervision and interpretation codes are to be used." This is what someone pointed out to me, that made me think that maybe I was missing some codes. What do you think? or anyone?

    Thanks again,
    Debi
    Please look the the Ultrasonic Guidance Procedures (76930 through 76965) or Radiologic Guidance (77001-77032) for further information. The Guidelines you are quoting refer to a physician both performing a surgical procedure and the S & I of the imaging. For example, if the radiologist does the sterotactic localization guidance for breast biopsy or needle placement, and also does the biopsy, he/she would be able to code both the biopsy (procedure) and the S & I (77031).

    If your provider is doing an ultrasound of the thyroid, and you are billing with no modifiers, the allowance includes both the technical and professional portions of the procedure. Your provider is already being paid for the work of interpreting and doing the report, as well as for the cost of using the equipment, etc. Our local allowance is as follows: Global = $104.28; TC (technical only) = $76.79; 26 (professional) = $27.49.

    I hope this helps.
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  5. #5
    Smile
    Wow. Great response. It was extremely helpful. Thanks so much, cmcgarry!

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