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Billing for Endoscopic Ultrasounds

  1. #1
    Exclamation Billing for Endoscopic Ultrasounds
    Medical Coding Books
    Has anyone had their GI docs perform EUS at the hospitals? If so, do you bill for the supervision and interpretation (76975 or 76942) ?? Most of the information that I have researched states that these codes are included in the GI codes (43259, 43242, 45341, 45342, 45391, 43231, 43238). If this is the case, what would the radiologist bill (if they do) when this is done at the hospital?

    Any feedback would be appreciated.

    Thank you!

  2. #2
    We code for a few physicians that perform EUS/EUS FNAs at the hospitals. We send through only the CPT for the appropriate EUS/EUS FNA. The CPT book specifically states not to use those S&I codes with certain CPTs.

    I've never seen a separate radiological report at the hospital from a radiologist so I'm not sure if the hospital bills out anything. As far as I'm aware, our physicians interpret the ultrasound solely themselves.

    ERCPs on the otherhand... we run into problems when the hospital radiologists bill out the S&I before we do. Our physicians do the S&I during the procedure. Their radiologist reads the images that are automatically routed to them afterwards and if they bill first, we get denied our payment.
    Redditor? Come join our coding/billing discussions on Reddit.

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