Getting paid: For ultrasound, follow extensive documentation, medical necessity rules

Why This Topic Matters

Ultrasound utilization is increasing in some physician settings, and payer rules can differ from fluoroscopy and may become more restrictive over time. Understanding the documentation and coverage framework helps reduce denials, recoupments, and billing errors.

Article Sections

1. Documentation: Record images permanently

   This section discusses documentation expectations for ultrasound services, including recordkeeping and reporting requirements. It also addresses distinctions between guidance and diagnostic ultrasound documentation.

2. Medical necessity: Justify imaging case by case

   This section covers the need to justify ultrasound use based on the patient and the clinical situation. It also notes the role of local coverage policies for certain ultrasound studies and the importance of checking payer-specific guidance.

3. Other points to keep in mind when coding and billing ultrasound

   This section summarizes additional coding and billing considerations for ultrasound in relation to other procedures and encounters. It also references national and contractor guidance sources relevant to reporting and bundling.