ULTRASOUND Messages for January, 2007: Re: ULTRASOUND digest 2658

Re: ULTRASOUND digest 2658
From: ACF (evsono@pipeline.com)
Fri Jan 19 13:29:18 2007

Messages sorted by: [ date ][ thread ][ subject ][ author ]
Previous message: DuBose, Terry: "Re: experience with reimbursement for 3D 4D ultrasound?"
In reply to: DuBose, Terry: "Re: experience with reimbursement for 3D 4D ultrasound?"

ultrasound@obgyn.net wrote: > ULTRASOUND Digest 2658
>
> Topics covered in this issue include:
>
> 1) Re: experience with reimbursement for 3D 4D ultrasound?
> by "Cheryl Turner" <cheryl_norris@hotmail.com>
> 2) RE: experience with reimbursement for 3D 4D ultrasound?
> by "R Depp" <Stork2001@comcast.net>
> 3) Re: experience with reimbursement for 3D 4D ultrasound?
> by Paula Woletz <pwoletz@aium.org>
> 4) RE: experience with reimbursement for 3D 4D ultrasound?
> by "DuBose, Terry" <DuboseTerryJ@uams.edu>
> 5) RE: experience with reimbursement for 3D 4D ultrasound?
> by "DuBose, Terry" <DuboseTerryJ@uams.edu>
> 6) RE: experience with reimbursement for 3D 4D ultrasound?
> by "DuBose, Terry" <DuboseTerryJ@uams.edu>
>
> ----------------------------------------------------------------------
>
> ----------------------------------------------------------------------
> Date: Fri, 19 Jan 2007 11:32:10 -0600
> ----------------------------------------------------------------------
> From: "Cheryl Turner" <cheryl_norris@hotmail.com>
> To: ultrasound@obgyn.net
> Subject: Re: experience with reimbursement for 3D 4D ultrasound?
> Message-ID: <BAY119-F97FA20B838E08BA56172682A90@phx.gbl>
> Mime-Version: 1.0
> Content-Type: text/plain; format=flowed
>
> 76376 is 3D rendering and interpretation and reporting of CT, MRI Ultrasound
> not requiring image postprocessing on and independent workstation
>
> 76377 is 3D requiring image postprocessing on an independent workstation
>
> what we are using, now whether we are getting paid? I dont know. We got this
> code from GE and its in the CPT 2006 code book
>
> Now with not only the ob 3D, but the STIC of the heart, and volume coronal
> plane for uterine polyps and uterine malformations, misplaced IUDs, volume
> measurements of lungs for diaphragmatic hernia repair, it can be justified
> for lots of things. Of course, that doesnt mean the insurance will pay.
>
> Cheryl Turner, BS, RDMS
> Inner Vision Women's Ultrasound
>
>> From: DuBoseTerryJ@UAMS.edu (Terry J DuBose)
>> Reply-To: ultrasound@obgyn.net
>> To: Multiple recipients of list ULTRASOUND <ultrasound@dns.obgyn.net>
>> Subject: Re: experience with reimbursement for 3D 4D ultrasound?
>> Date: Fri, 19 Jan 2007 11:11:08 -0600
>>
>> This reimbursment issue has come up again with our folks. Does anyone
>> in the USA have anything new, or answers to the question:
>>
>> "Yes i have been searching AIUM and ACOG....but nothing.....as far as i
>> know there is NO CPT code......
>> this is one thing we are working on: I guess we are going to make some
>> kind of guideline maybe.....do you have any suggestions....."
>>
>> "I need for you to look up a good description of what thins we should
>> allow the 3-d 4- us to be applied to. i.e. heart? Cleft lip palette?
>> Spine? May be we could also limit it to AIUM certified labs. Judith
>> wants this."
>>
>> Thanks, Terry
>>
>> ---------------------------
>>
>> ---------------------------
>> At Wed, 18 Jan 2006, James Smeltzer wrote:
>> ---------------------------
>>
>>> Hi! Color flow mapping is 93325. Paid at about $4 when we get paid.
>>> Offline 3-D code I know about was developed for 3-D post-processed
>>> analysis of MRI & CTS. We have only used a few times. I only have one
>>> case of DS not diagnosed by 2-D but done by 3-D on facial morphology -
>>> which was quiet clear. What CPT are you talking about? JimS
>>>
>>> --
>>> James S. Smeltzer, MD, FACOG, SMFM
>>> Consultant, Maternal Fetal Medicine
>>> Wellstar Physicians' Group
>>> Northwest Women's Care
>>> 787 Campbell Hill St
>>> Marietta GA 30060
>>> James.Smeltzer@wellstar.org
>>> VM 678-290-3035
>>> Off 770-528-0260
>>> Page 404-318-3451
>>>
>>>>>> sylultra@hotmail.com 1/15/2006 1:50:54 PM >>>
>>>>>>
>>> At Tue, 19 Jun 2001, phillipsbill wrote:
>>>
>>>> Does anyone have experience with reimbursement for 3D ultrasound?
>>>>
>>> We have been billing the code for almost 3 years for Abd, OB/GYN, and
>>> small parts with success however Aetna and Cigna insurance companies
>>> are
>>> not paying for the code. Aetna states that as of 4/1/06 they will
>>> discontinue the new codes as they are incidental to the scan. Cigna
>>> states that the 3D is still investigational.
>>>
>>> At the present one of our insurance companies is now requesting
>>> repayment of the code for the past 2 years even though it was done in
>>> conjunction with our regular code and not billed routinely for OB/GYN,
>>> Abdominal, or small parts. We only bill when the images we obtain
>>> give
>>> us diagnostic value and we are fighting this request. If you have any
>>> insight I would appreciate a response.
>>>
>>> Do you have any specific questions? Also do you have any experience
>>> with
>>> color flow billing?
>>>
>>> Thanks,
>>> Rose
>>>
>
> _________________________________________________________________
> Type your favorite song. Get a customized station. Try MSN Radio powered
> _________________________________________________________________
> by Pandora. http://radio.msn.com/?icid=T002MSN03A07001
>
> ------------------------------
>
> ------------------------------
> Date: Fri, 19 Jan 2007 12:52:26 -0500
> ------------------------------
> From: "R Depp" <Stork2001@comcast.net>
> To: <ultrasound@obgyn.net>,
> "'Multiple recipients of list ULTRASOUND'" <ultrasound@dns.obgyn.net>
> Subject: RE: experience with reimbursement for 3D 4D ultrasound?
> Message-ID: <003b01c73bf2$94b80200$6601a8c0@DUCOM.edu>
> MIME-Version: 1.0
> Content-Type: text/plain;
> charset="iso-8859-1"
> Content-Transfer-Encoding: 8bit
>
> The SMFM Website has access to a Coding area which addresses circumstances
> for coding, appropriate codes, indications etc. The group has for instance
> working with AETNA to come up with codes for NT which become active this
> month (requires discussion with regional insurers). Your practices /
> billing service can have access to this coding service for a nominal yearly
> fee which most feel is the PLACE. Many of the insurers, including AETNA use
> the site as the arbitrator for OB and GYN ultrasounds - thanks to the work
> of Dan O'Keeffe and others.
>
> I am no expert on coding, but understand that the number of units for post
> processing is small and the reimbursement is small, that most of
> reimbursement is in the technical component. Not a fact, but my memory.
>
> rd
>
> Richard Depp, MD
> Exec VP, Society for Maternal Fetal Medicine
> 1280 Club House Road
> Gladwyne, PA 19035
> 610-527-5712 (NEW)
>
> -----Original Message-----
> From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of Cheryl
> Turner
> Sent: Friday, January 19, 2007 12:35 PM
> To: Multiple recipients of list ULTRASOUND
> Subject: Re: experience with reimbursement for 3D 4D ultrasound?
>
> 76376 is 3D rendering and interpretation and reporting of CT, MRI Ultrasound
>
> not requiring image postprocessing on and independent workstation
>
> 76377 is 3D requiring image postprocessing on an independent workstation
>
> what we are using, now whether we are getting paid? I dont know. We got this
>
> code from GE and its in the CPT 2006 code book
>
> Now with not only the ob 3D, but the STIC of the heart, and volume coronal
> plane for uterine polyps and uterine malformations, misplaced IUDs, volume
> measurements of lungs for diaphragmatic hernia repair, it can be justified
> for lots of things. Of course, that doesnt mean the insurance will pay.
>
> Cheryl Turner, BS, RDMS
> Inner Vision Women's Ultrasound
>
>> From: DuBoseTerryJ@UAMS.edu (Terry J DuBose)
>> Reply-To: ultrasound@obgyn.net
>> To: Multiple recipients of list ULTRASOUND <ultrasound@dns.obgyn.net>
>> Subject: Re: experience with reimbursement for 3D 4D ultrasound?
>> Date: Fri, 19 Jan 2007 11:11:08 -0600
>>
>> This reimbursment issue has come up again with our folks. Does anyone
>> in the USA have anything new, or answers to the question:
>>
>> "Yes i have been searching AIUM and ACOG....but nothing.....as far as i
>> know there is NO CPT code......
>> this is one thing we are working on: I guess we are going to make some
>> kind of guideline maybe.....do you have any suggestions....."
>>
>> "I need for you to look up a good description of what thins we should
>> allow the 3-d 4- us to be applied to. i.e. heart? Cleft lip palette?
>> Spine? May be we could also limit it to AIUM certified labs. Judith
>> wants this."
>>
>> Thanks, Terry
>>
>> ---------------------------
>>
>> ---------------------------
>> At Wed, 18 Jan 2006, James Smeltzer wrote:
>> ---------------------------
>>
>>> Hi! Color flow mapping is 93325. Paid at about $4 when we get paid.
>>> Offline 3-D code I know about was developed for 3-D post-processed
>>> analysis of MRI & CTS. We have only used a few times. I only have one
>>> case of DS not diagnosed by 2-D but done by 3-D on facial morphology -
>>> which was quiet clear. What CPT are you talking about? JimS
>>>
>>> --
>>> James S. Smeltzer, MD, FACOG, SMFM
>>> Consultant, Maternal Fetal Medicine
>>> Wellstar Physicians' Group
>>> Northwest Women's Care
>>> 787 Campbell Hill St
>>> Marietta GA 30060
>>> James.Smeltzer@wellstar.org
>>> VM 678-290-3035
>>> Off 770-528-0260
>>> Page 404-318-3451
>>>
>>>>>> sylultra@hotmail.com 1/15/2006 1:50:54 PM >>>
>>>>>>
>>> At Tue, 19 Jun 2001, phillipsbill wrote:
>>>
>>>> Does anyone have experience with reimbursement for 3D ultrasound?
>>>>
>>> We have been billing the code for almost 3 years for Abd, OB/GYN, and
>>> small parts with success however Aetna and Cigna insurance companies
>>> are
>>> not paying for the code. Aetna states that as of 4/1/06 they will
>>> discontinue the new codes as they are incidental to the scan. Cigna
>>> states that the 3D is still investigational.
>>>
>>> At the present one of our insurance companies is now requesting
>>> repayment of the code for the past 2 years even though it was done in
>>> conjunction with our regular code and not billed routinely for OB/GYN,
>>> Abdominal, or small parts. We only bill when the images we obtain
>>> give
>>> us diagnostic value and we are fighting this request. If you have any
>>> insight I would appreciate a response.
>>>
>>> Do you have any specific questions? Also do you have any experience
>>> with
>>> color flow billing?
>>>
>>> Thanks,
>>> Rose
>>>
>
> _________________________________________________________________
> Type your favorite song. Get a customized station. Try MSN Radio powered
> _________________________________________________________________
> by Pandora. http://radio.msn.com/?icid=T002MSN03A07001
>
> ------------------------------
>
> ------------------------------
> Date: Fri, 19 Jan 2007 13:04:32 -0500
> ------------------------------
> From: Paula Woletz <pwoletz@aium.org>
> To: ultrasound@obgyn.net
> Subject: Re: experience with reimbursement for 3D 4D ultrasound?
> Message-ID: <6.1.2.0.0.20070119125500.01dd8248@Server1b.aium.org>
> Mime-Version: 1.0
> Content-Type: multipart/alternative;
> boundary="=====================_16119828==.ALT"
>
> --=====================_16119828==.ALT
> Content-Type: text/plain; charset="us-ascii"; format=flowed
>
> Are you looking for a CPT code for 3D?
>
> 76376: "3D rendering with interpretation and reporting of computed
> tomography, magnetic resonance imaging, ultrasound, or other tomographic
> modality; not requiring image postprocessing on an independent workstation.
> (Use 76376 in conjunction with codes[s] for base imaging procedure[s])"
>
> 76377: " 3D rendering with interpretation and reporting of computed
> tomography, magnetic resonance imaging, ultrasound, or other tomographic
> modality; requiring image postprocessing on an independent
> workstation. (Use 76377 in conjunction with codes[s] for base imaging
> procedure[s])"
>
> Hope this helps!
> Paula
>
> At 12:10 PM 1/19/2007, you wrote:
>
>> This reimbursment issue has come up again with our folks. Does anyone
>> in the USA have anything new, or answers to the question:
>>
>> "Yes i have been searching AIUM and ACOG....but nothing.....as far as i
>> know there is NO CPT code......
>> this is one thing we are working on: I guess we are going to make some
>> kind of guideline maybe.....do you have any suggestions....."
>>
>> "I need for you to look up a good description of what thins we should
>> allow the 3-d 4- us to be applied to. i.e. heart? Cleft lip palette?
>> Spine? May be we could also limit it to AIUM certified labs. Judith
>> wants this."
>>
>> Thanks, Terry
>>
>
> Paula S. Woletz, MPH, RDMS, RDCS, FAIUM
> Director of Accreditation and Clinical Affairs
> American Institute of Ultrasound in Medicine
> 14750 Sweitzer Lane, Suite 100
> Laurel, MD 20707-5906
> (301) 498-4100
> (800) 638-5352
>
> --=====================_16119828==.ALT
> Content-Type: text/html; charset="us-ascii"
>
> <html>
> <body>
> Are you looking for a CPT code for 3D? 
> 76376:  "3D rendering with interpretation and reporting of
> computed tomography, magnetic resonance imaging, ultrasound, or other
> tomographic modality; not requiring image postprocessing on an
> independent workstation. (Use 76376 in conjunction with codes[s] for base
> imaging procedure[s])" 
> 76377: " 3D rendering with interpretation and reporting of computed
> tomography, magnetic resonance imaging, ultrasound, or other tomographic
> modality; requiring image postprocessing on an independent
> workstation.  (Use 76377 in conjunction with codes[s] for base
> imaging procedure[s])" 
> Hope this helps! 
> Paula 
> 
> At 12:10 PM 1/19/2007, you wrote: 
> <blockquote type=cite class=cite cite="">This reimbursment issue has come
> up again with our folks.  Does anyone 
> in the USA have anything new, or answers to the question: 
> "Yes i have been searching AIUM and ACOG....but nothing.....as far
> as i 
> know there is NO CPT code...... 
> this is one thing we are working on: I guess we are going to make
> some 
> kind of guideline maybe.....do you have any
> suggestions....." 
> "I need for you to look up a good description of what thins we
> should 
> allow the 3-d 4- us to be applied to.  i.e.  heart? Cleft lip
> palette? 
> Spine? May be we could also limit it to AIUM certified labs. 
> Judith 
> wants this." 
> Thanks, Terry 
> 
> </blockquote>
> <x-sigsep></x-sigsep>
> <div align="center">Paula S. Woletz, MPH, RDMS, RDCS, FAIUM 
> Director of Accreditation and Clinical Affairs 
> American Institute of Ultrasound in Medicine 
> 14750 Sweitzer Lane, Suite 100 
> Laurel, MD 20707-5906 
> (301) 498-4100 
> (800) 638-5352 
> </div>
> </body>
> </html>
>
> --=====================_16119828==.ALT--
>
> ------------------------------
>
> ------------------------------
> Date: Fri, 19 Jan 2007 13:34:12 -0600
> ------------------------------
> From: "DuBose, Terry" <DuboseTerryJ@uams.edu>
> To: ultrasound@obgyn.net,
> "Multiple recipients of list ULTRASOUND" <ultrasound@dns.obgyn.net>
> Subject: RE: experience with reimbursement for 3D 4D ultrasound?
> Message-ID: <590F08A18A72AF46917BF721E6476B5C0C3FD6D3@EXCHANGE2.ad.uams.edu>
> Content-class: urn:content-classes:message
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>
> Paula, I think that is exactly what we are looking for. Thanks very much.>
> Mandi, will this help?
>
> Terry J. DuBose, M.S., RDMS, FSDMS, FAIUM
>
> Associate Professor & Director
> Diagnostic Medical Sonography Program
> University of Arkansas for Medical Sciences, CHRP
> 4301 West Markham St. Mail Slot #563
> Little Rock, Arkansas, 72205 USA
> 501-686-6510 or 501-686-5948
> DuBoseTerryJ@UAMS.edu
> http://www.uams.edu/chrp/sonography/
> http://www.obgyn.net/us/panel/panel.htm
> http://www.io.com/~dubose/
> ---------------------------------------------------------------
>
> ---------------------------------------------------------------
> ________________________________
> ---------------------------------------------------------------
>
> From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of > Paula
> Woletz
> Sent: Friday, January 19, 2007 12:08 PM
> To: Multiple recipients of list ULTRASOUND
> Subject: Re: experience with reimbursement for 3D 4D ultrasound?
>
> Are you looking for a CPT code for 3D?
>
> 76376: "3D rendering with interpretation and reporting of computed
> tomography, magnetic resonance imaging, ultrasound, or other tomographic
> modality; not requiring image postprocessing on an independent workstation.
> (Use 76376 in conjunction with codes[s] for base imaging procedure[s])"
>
> 76377: " 3D rendering with interpretation and reporting of computed
> tomography, magnetic resonance imaging, ultrasound, or other tomographic
> modality; requiring image postprocessing on an independent workstation. > (Use
> 76377 in conjunction with codes[s] for base imaging procedure[s])"
>
> Hope this helps!
> Paula
>
> At 12:10 PM 1/19/2007, you wrote:
>
> This reimbursment issue has come up again with our folks. Does anyone
> in the USA have anything new, or answers to the question:
>
> "Yes i have been searching AIUM and ACOG....but nothing.....as far as i
> know there is NO CPT code......
> this is one thing we are working on: I guess we are going to make some
> kind of guideline maybe.....do you have any suggestions....."
>
> "I need for you to look up a good description of what thins we should
> allow the 3-d 4- us to be applied to. i.e. heart? Cleft lip palette?
> Spine? May be we could also limit it to AIUM certified labs. Judith
> wants this."
>
> Thanks, Terry
>
> Paula S. Woletz, MPH, RDMS, RDCS, FAIUM
> Director of Accreditation and Clinical Affairs
> American Institute of Ultrasound in Medicine
> 14750 Sweitzer Lane, Suite 100
> Laurel, MD 20707-5906
> (301) 498-4100
> (800) 638-5352
>
> Confidentiality Notice: This e-mail message, including any attachments, is > for the sole use of the intended recipient(s) and may contain confidentia> l> and privileged information. Any unauthorized review, use, disclosure or > distribution is prohibited. If you are not the intended recipient, please > contact the sender by reply e-mail and destroy all copies of the original > message.
>
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> style='font-size:
> 12.0pt;font-family:Arial;color:green'>Paula, I think that is exactly what we
> are looking for.   Thanks very much. <o:p></o:p>
>
> style='font-size:
> 12.0pt;font-family:Arial;color:green'><o:p> </o:p>
>
> style='font-size:
> 12.0pt;font-family:Arial;color:green'>Mandi, will this > help?<o:p></o:p>
>
> style='font-size:
> 12.0pt;font-family:Arial;color:green'><o:p> </o:p>
>
> <div>
>
> s> New Roman"><span
> style='font-size:10.0pt;color:green'>Terry J. DuBose, M.S., RDMS, FSDMS, > FAIUM 
> 
> Associate Professor & Director 
> Diagnostic Medical Sonography Program 
> <st1:place w:st="on"><st1:PlaceType w:st="on">University</st1:PlaceType>
>> >>
> of <st1:PlaceName
> w:st="on">Arkansas</st1:PlaceName></st1:place> for Medical Sciences, > CHRP 
> <st1:Street w:st="on"><st1:address w:st="on">4301 West Markham > St.</st1:address></st1:Street>
> Mail Slot #563 
> <st1:place w:st="on"><st1:City w:st="on">Little Rock</st1:City>, > <st1:State
> w:st="on">Arkansas</st1:State>, <st1:PostalCode > w:st="on">72205</st1:PostalCode>
> <st1:country-region w:st="on">USA</st1:country-region></st1:place> 
> 501-686-6510 or 501-686-5948 
> DuBoseTerryJ@UAMS.edu 
> <a > href="http://www.uams.edu/chrp/sonography/">http://www.uams.edu/chrp/sono> graphy/</a> 
> <a > href="http://www.obgyn.net/us/panel/panel.htm">http://www.obgyn.net/us/pa> nel/panel.htm</a> 
> <a href="http://www.io.com/~dubose/">http://www.io.com/~dubose/</a> 
> ---------------------------------------------------------------</fon> t><font
> ---------------------------------------------------------------</fon> size=3D2><o:p></o:p>
> ---------------------------------------------------------------</fon>
> </div>
>
> <div>
>
> <div class=MsoNormal alignÎnter > style='margin-left:.5in;text-align:center'><font
> size=3 face="Times New Roman">
>
> <hr size=2 width="100%" alignÎnter tabindex=-1>
>
> </div>
>
> face=Tahoma><span
> style='font-size:10.0pt;font-family:Tahoma;font-weight:bold'>From:> <font
> size=2 face=Tahoma>> > <st1:PersonName
> w:st="on">ultrasound@obgyn.net</st1:PersonName> [mailto:<st1:PersonName > w:st="on">ultrasound@obgyn.net</st1:PersonName>]
> On Behalf Of Paula Woletz 
> Sent: Friday, January 19, > 2007
> 12:08 PM 
> To: Multiple recipients of > list
> ULTRASOUND 
> Subject: Re: experience with
> reimbursement for 3D 4D ultrasound?<o:p></o:p>
>
> </div>
>
> s> New Roman"><span
> style='font-size:12.0pt'><o:p> </o:p>
>
> s> New Roman"><span
> style='font-size:12.0pt'>Are you looking for a CPT code for 3D? 
> 
> 76376:  "3D rendering with interpretation and reporting of > computed
> tomography, magnetic resonance imaging, ultrasound, or other tomographic
> modality; not requiring image postprocessing on an independent workstation.
> (Use 76376 in conjunction with codes[s] for base imaging > procedure[s])" 
> 
> 76377: " 3D rendering with interpretation and reporting of computed
> tomography, magnetic resonance imaging, ultrasound, or other tomographic
> modality; requiring image postprocessing on an independent > workstation. 
> (Use 76377 in conjunction with codes[s] for base imaging > procedure[s])" 
> 
> Hope this helps! 
> Paula 
> 
> At 12:10 PM 1/19/2007, you wrote: 
> 
> <o:p></o:p>
>
> style='mso-margin-top-alt:0in;margin-right:0in;margin-bottom:
> 12.0pt;margin-left:.5in'><span
> style='font-size:12.0pt'>This reimbursment issue has come up again with > our
> folks.  Does anyone 
> in the <st1:country-region w:st="on"><st1:place > w:st="on">USA</st1:place></st1:country-region>
> have anything new, or answers to the question: 
> 
> "Yes i have been searching AIUM and ACOG....but nothing.....as far as > i 
> know there is NO CPT code...... 
> this is one thing we are working on: I guess we are going to make some 
> kind of guideline maybe.....do you have any suggestions....." 
> 
> "I need for you to look up a good description of what thins we > should 
> allow the 3-d 4- us to be applied to.  i.e.  heart? Cleft lip
> palette? 
> Spine? May be we could also limit it to AIUM certified labs.  > Judith 
> wants this." 
> 
> Thanks, Terry<o:p></o:p>
>
> style='margin-left:.5in;text-align:center'></x-sigsep><font
> size=3 face="Times New Roman"> style='font-size:12.0pt'><x-sigsep>Paula S.
> Woletz, MPH, RDMS, RDCS, FAIUM 
> Director of Accreditation and Clinical Affairs 
> American Institute of Ultrasound in Medicine 
> <st1:Street w:st="on"><st1:address w:st="on">14750 Sweitzer Lane, Suite> > 100</st1:address></st1:Street> 
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> (301) 498-4100 
> (800) 638-5352<o:p></o:p>
>
> </div>
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> ------_=_NextPart_001_01C73C00.CC6299FA--
>
> ------------------------------
>
> ------------------------------
> Date: Fri, 19 Jan 2007 13:36:41 -0600
> ------------------------------
> From: "DuBose, Terry" <DuboseTerryJ@uams.edu>
> To: ultrasound@obgyn.net,
> "Multiple recipients of list ULTRASOUND" <ultrasound@dns.obgyn.net>
> Subject: RE: experience with reimbursement for 3D 4D ultrasound?
> Message-ID: <590F08A18A72AF46917BF721E6476B5C0C3FD6E2@EXCHANGE2.ad.uams.edu>
> Content-class: urn:content-classes:message
> MIME-Version: 1.0
> Content-Type: text/plain;
> charset=iso-8859-1
> Content-Transfer-Encoding: 8bit
>
> Thanks very much for the input. Terry
>
> Terry J. DuBose, M.S., RDMS, FSDMS, FAIUM
>
> Associate Professor & Director
> Diagnostic Medical Sonography Program
> University of Arkansas for Medical Sciences, CHRP
> 4301 West Markham St. Mail Slot #563
> Little Rock, Arkansas, 72205 USA
> 501-686-6510 or 501-686-5948
> DuBoseTerryJ@UAMS.edu
> http://www.uams.edu/chrp/sonography/
> http://www.obgyn.net/us/panel/panel.htm
> http://www.io.com/~dubose/
> ---------------------------------------------------------------
>
> ---------------------------------------------------------------
>
> ---------------------------------------------------------------
>
> -----Original Message-----
> From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of R Depp
> Sent: Friday, January 19, 2007 11:55 AM
> To: Multiple recipients of list ULTRASOUND
> Subject: RE: experience with reimbursement for 3D 4D ultrasound?
>
> The SMFM Website has access to a Coding area which addresses circumstances
> for coding, appropriate codes, indications etc. The group has for instance
> working with AETNA to come up with codes for NT which become active this
> month (requires discussion with regional insurers). Your practices /
> billing service can have access to this coding service for a nominal yearly
> fee which most feel is the PLACE. Many of the insurers, including AETNA use
> the site as the arbitrator for OB and GYN ultrasounds - thanks to the work
> of Dan O'Keeffe and others.
>
> I am no expert on coding, but understand that the number of units for post
> processing is small and the reimbursement is small, that most of
> reimbursement is in the technical component. Not a fact, but my memory.
>
> rd
>
> Richard Depp, MD
> Exec VP, Society for Maternal Fetal Medicine
> 1280 Club House Road
> Gladwyne, PA 19035
> 610-527-5712 (NEW)
>
> -----Original Message-----
> From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of Cheryl
> Turner
> Sent: Friday, January 19, 2007 12:35 PM
> To: Multiple recipients of list ULTRASOUND
> Subject: Re: experience with reimbursement for 3D 4D ultrasound?
>
> 76376 is 3D rendering and interpretation and reporting of CT, MRI Ultrasound
>
> not requiring image postprocessing on and independent workstation
>
> 76377 is 3D requiring image postprocessing on an independent workstation
>
> what we are using, now whether we are getting paid? I dont know. We got this
>
> code from GE and its in the CPT 2006 code book
>
> Now with not only the ob 3D, but the STIC of the heart, and volume coronal
> plane for uterine polyps and uterine malformations, misplaced IUDs, volume
> measurements of lungs for diaphragmatic hernia repair, it can be justified
> for lots of things. Of course, that doesnt mean the insurance will pay.
>
> Cheryl Turner, BS, RDMS
> Inner Vision Women's Ultrasound
>
>> From: DuBoseTerryJ@UAMS.edu (Terry J DuBose)
>> Reply-To: ultrasound@obgyn.net
>> To: Multiple recipients of list ULTRASOUND <ultrasound@dns.obgyn.net>
>> Subject: Re: experience with reimbursement for 3D 4D ultrasound?
>> Date: Fri, 19 Jan 2007 11:11:08 -0600
>>
>> This reimbursment issue has come up again with our folks. Does anyone
>> in the USA have anything new, or answers to the question:
>>
>> "Yes i have been searching AIUM and ACOG....but nothing.....as far as i
>> know there is NO CPT code......
>> this is one thing we are working on: I guess we are going to make some
>> kind of guideline maybe.....do you have any suggestions....."
>>
>> "I need for you to look up a good description of what thins we should
>> allow the 3-d 4- us to be applied to. i.e. heart? Cleft lip palette?
>> Spine? May be we could also limit it to AIUM certified labs. Judith
>> wants this."
>>
>> Thanks, Terry
>>
>> ---------------------------
>>
>> ---------------------------
>> At Wed, 18 Jan 2006, James Smeltzer wrote:
>> ---------------------------
>>
>>> Hi! Color flow mapping is 93325. Paid at about $4 when we get paid.
>>> Offline 3-D code I know about was developed for 3-D post-processed
>>> analysis of MRI & CTS. We have only used a few times. I only have one
>>> case of DS not diagnosed by 2-D but done by 3-D on facial morphology -
>>> which was quiet clear. What CPT are you talking about? JimS
>>>
>>> --
>>> James S. Smeltzer, MD, FACOG, SMFM
>>> Consultant, Maternal Fetal Medicine
>>> Wellstar Physicians' Group
>>> Northwest Women's Care
>>> 787 Campbell Hill St
>>> Marietta GA 30060
>>> James.Smeltzer@wellstar.org
>>> VM 678-290-3035
>>> Off 770-528-0260
>>> Page 404-318-3451
>>>
>>>>>> sylultra@hotmail.com 1/15/2006 1:50:54 PM >>>
>>>>>>
>>> At Tue, 19 Jun 2001, phillipsbill wrote:
>>>
>>>> Does anyone have experience with reimbursement for 3D ultrasound?
>>>>
>>> We have been billing the code for almost 3 years for Abd, OB/GYN, and
>>> small parts with success however Aetna and Cigna insurance companies
>>> are
>>> not paying for the code. Aetna states that as of 4/1/06 they will
>>> discontinue the new codes as they are incidental to the scan. Cigna
>>> states that the 3D is still investigational.
>>>
>>> At the present one of our insurance companies is now requesting
>>> repayment of the code for the past 2 years even though it was done in
>>> conjunction with our regular code and not billed routinely for OB/GYN,
>>> Abdominal, or small parts. We only bill when the images we obtain
>>> give
>>> us diagnostic value and we are fighting this request. If you have any
>>> insight I would appreciate a response.
>>>
>>> Do you have any specific questions? Also do you have any experience
>>> with
>>> color flow billing?
>>>
>>> Thanks,
>>> Rose
>>>
>
> _________________________________________________________________
> Type your favorite song. Get a customized station. Try MSN Radio powered
> _________________________________________________________________
> by Pandora. http://radio.msn.com/?icid=T002MSN03A07001
>
> Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
>
> ------------------------------
>
> ------------------------------
> Date: Fri, 19 Jan 2007 13:44:44 -0600
> ------------------------------
> From: "DuBose, Terry" <DuboseTerryJ@uams.edu>
> To: ultrasound@obgyn.net
> Subject: RE: experience with reimbursement for 3D 4D ultrasound?
> Message-ID: <590F08A18A72AF46917BF721E6476B5C0C3FD704@EXCHANGE2.ad.uams.edu>
> Content-class: urn:content-classes:message
> MIME-Version: 1.0
> Content-Type: text/plain;
> charset=iso-8859-1
> Content-Transfer-Encoding: 8bit
>
> Thank you.
>
> Terry J. DuBose, M.S., RDMS, FSDMS, FAIUM
>
> Associate Professor & Director
> Diagnostic Medical Sonography Program
> University of Arkansas for Medical Sciences, CHRP
> 4301 West Markham St. Mail Slot #563
> Little Rock, Arkansas, 72205 USA
> 501-686-6510 or 501-686-5948
> DuBoseTerryJ@UAMS.edu
> http://www.uams.edu/chrp/sonography/
> http://www.obgyn.net/us/panel/panel.htm
> http://www.io.com/~dubose/
> ---------------------------------------------------------------
>
> ---------------------------------------------------------------
>
> ---------------------------------------------------------------
>
> -----Original Message-----
> From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of Cheryl
> Turner
> Sent: Friday, January 19, 2007 11:35 AM
> To: Multiple recipients of list ULTRASOUND
> Subject: Re: experience with reimbursement for 3D 4D ultrasound?
>
> 76376 is 3D rendering and interpretation and reporting of CT, MRI Ultrasound
> not requiring image postprocessing on and independent workstation
>
> 76377 is 3D requiring image postprocessing on an independent workstation
>
> what we are using, now whether we are getting paid? I dont know. We got this
> code from GE and its in the CPT 2006 code book
>
> Now with not only the ob 3D, but the STIC of the heart, and volume coronal
> plane for uterine polyps and uterine malformations, misplaced IUDs, volume
> measurements of lungs for diaphragmatic hernia repair, it can be justified
> for lots of things. Of course, that doesnt mean the insurance will pay.
>
> Cheryl Turner, BS, RDMS
> Inner Vision Women's Ultrasound
>
>> From: DuBoseTerryJ@UAMS.edu (Terry J DuBose)
>> Reply-To: ultrasound@obgyn.net
>> To: Multiple recipients of list ULTRASOUND <ultrasound@dns.obgyn.net>
>> Subject: Re: experience with reimbursement for 3D 4D ultrasound?
>> Date: Fri, 19 Jan 2007 11:11:08 -0600
>>
>> This reimbursment issue has come up again with our folks. Does anyone
>> in the USA have anything new, or answers to the question:
>>
>> "Yes i have been searching AIUM and ACOG....but nothing.....as far as i
>> know there is NO CPT code......
>> this is one thing we are working on: I guess we are going to make some
>> kind of guideline maybe.....do you have any suggestions....."
>>
>> "I need for you to look up a good description of what thins we should
>> allow the 3-d 4- us to be applied to. i.e. heart? Cleft lip palette?
>> Spine? May be we could also limit it to AIUM certified labs. Judith
>> wants this."
>>
>> Thanks, Terry
>>
>> ---------------------------
>>
>> ---------------------------
>> At Wed, 18 Jan 2006, James Smeltzer wrote:
>> ---------------------------
>>
>>> Hi! Color flow mapping is 93325. Paid at about $4 when we get paid.
>>> Offline 3-D code I know about was developed for 3-D post-processed
>>> analysis of MRI & CTS. We have only used a few times. I only have one
>>> case of DS not diagnosed by 2-D but done by 3-D on facial morphology -
>>> which was quiet clear. What CPT are you talking about? JimS
>>>
>>> --
>>> James S. Smeltzer, MD, FACOG, SMFM
>>> Consultant, Maternal Fetal Medicine
>>> Wellstar Physicians' Group
>>> Northwest Women's Care
>>> 787 Campbell Hill St
>>> Marietta GA 30060
>>> James.Smeltzer@wellstar.org
>>> VM 678-290-3035
>>> Off 770-528-0260
>>> Page 404-318-3451
>>>
>>>>>> sylultra@hotmail.com 1/15/2006 1:50:54 PM >>>
>>>>>>
>>> At Tue, 19 Jun 2001, phillipsbill wrote:
>>>
>>>> Does anyone have experience with reimbursement for 3D ultrasound?
>>>>
>>> We have been billing the code for almost 3 years for Abd, OB/GYN, and
>>> small parts with success however Aetna and Cigna insurance companies
>>> are
>>> not paying for the code. Aetna states that as of 4/1/06 they will
>>> discontinue the new codes as they are incidental to the scan. Cigna
>>> states that the 3D is still investigational.
>>>
>>> At the present one of our insurance companies is now requesting
>>> repayment of the code for the past 2 years even though it was done in
>>> conjunction with our regular code and not billed routinely for OB/GYN,
>>> Abdominal, or small parts. We only bill when the images we obtain
>>> give
>>> us diagnostic value and we are fighting this request. If you have any
>>> insight I would appreciate a response.
>>>
>>> Do you have any specific questions? Also do you have any experience
>>> with
>>> color flow billing?
>>>
>>> Thanks,
>>> Rose
>>>
>
> _________________________________________________________________
> Type your favorite song. Get a customized station. Try MSN Radio powered
> _________________________________________________________________
> by Pandora. http://radio.msn.com/?icid=T002MSN03A07001
>
> Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
>
> ------------------------------
>
> ------------------------------
> End of ULTRASOUND Digest 2658
> ------------------------------
> *****************************
>
>

There should also be a code developed for 3D Ultrasound to evaluate the endometrial cavity, 3d sonohysterography, 3d uterine malformations, 3D r/o interstitial pregnancy, etc.
A word of caution - Just because a code exists doesn't guarantee reimbursement.
Art

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