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

Why This Topic Matters

Ultrasound use has increased in physician practices, and the article focuses on why documentation and coverage rules matter for avoiding denials, recoupments, and other payment problems.

Article Sections

1. Ultrasound use in physician practices

   Introduces the growing use of ultrasound for office-based imaging guidance and contrasts it with other imaging approaches in general terms. It also frames the reimbursement and workflow context for the topic.

2. Documentation: Record images permanently

   Covers the documentation expectations for ultrasound services, including permanent image retention and written reporting requirements. It also discusses the scope of documentation for extremity studies and complete versus limited exams.

3. Medical necessity: Justify imaging case by case

   Explains the need to support ultrasound use on an individual-patient basis and references payer coverage considerations for extremity studies. It also notes examples of clinically relevant situations and local coverage review.

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

   Summarizes additional billing and coding considerations involving ultrasound guidance, diagnostic ultrasound, and related procedures. It also notes policy references from CPT guidance and the National Correct Coding Initiative.