decisionhealth Newsletters, Part B News - 2007 Issue 10 (October)
Ultrasound: 4 things you should remember to bill ultrasound services correctly; OIG plans to look for excessive ultrasound usage in 2008
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Article Overview
This article is about ultrasound billing compliance in physician practices, with emphasis on Medicare oversight, utilization review, documentation, supervision, and procedure completeness. It is aimed at coders, billers, and practice managers who need to understand the general kinds of ultrasound claims issues that may attract denials or audit attention.
Why This Topic Matters
Ultrasound services are a frequent focus of medical necessity review and claim denial review. Understanding the broad compliance issues covered here can help practices assess whether their billing, documentation, and supervision processes align with payer expectations.
Article Sections
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OIG plans to look for excessive ultrasound usage in 2008
Summarizes the government interest in ultrasound utilization and the Medicare billing context discussed in the article. It also introduces the regional usage focus and the general compliance concerns raised by consultants.
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4 things to remember about ultrasounds
Reviews the major billing and documentation areas highlighted for ultrasound services. The section covers diagnosis specificity, patient assessment, supervision, and adherence to CPT-based procedural requirements.
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In case OIG does come knocking, be prepared for a thorough inspection.
Describes the types of records and materials that may be requested during a review. It reinforces the article’s compliance and audit-preparedness theme.
What You Will Learn
- How ultrasound utilization review can affect physician practices
- Why documentation quality matters for ultrasound claims
- What general compliance areas are emphasized for ultrasound services
- What kinds of records may be requested during an audit or inspection
Who Should Read This
- Medical coders
- Medical billers
- Practice managers
- Compliance staff
- Physician office staff
Codes Discussed
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