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billing pelvic sonograms with endovaginal procedure From: Pamela (pwickkiser@msn.com) Mon Oct 22 20:28:21 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dave Berck: "Re: Hiccup in BPP" Previous message: Lori Green: "Fetal Heart Webinar: Educational Opportunity" What is the standard of care when ordering an ultrasound of the pelvis for indications like enlarged uterus, DUB or pelvic pain? There seems to be some controversy over whether to order a transvag vs transabdominal My personal opinion is to order the transabdominal to obtain an overview and then order the endovag if further investigation is needed. When we perform both of these exams they are billed. Is this the protocol used by OB/GYN's? Some of my OB/GYN's are insisting that just endovag should be performed. I understand when the the indication is for Postmenopausal bleeding or early preg needs to be have an endovag. At Sat, 25 Sep 1999, James S Smeltzer MD wrote: > >Sergio, > >Anything that is done for a specific medical indication for the benefit of >the patient as an additional procedure should be billed, with the >applicable specific indication as the ICD9 for the additional procedure on >the HCFA-1500. What they pay for is another matter, entirely. Some payers >may require a prior authorization for this. If it is medically indicated >you should do it & then worry about payment. > >For example, We do a lot of "free" biophysical profiles with our later >sonograms as an adjunct to a regular sonogram. When we are doing a study >for IUGR, we code & bill for this service, but also give juice and wait 20 >min for breathing and perform a nonstress test if needed. > >If you cannot see the cervix well and do a vaginal examination for a >history of preterm, then you should perform and code for the vag study >using V23.4 as the indication. If there is no specific indication we do not >bill for it, but neither are the sonographers required to do it, as they >are with a positive history. > >In general each and every procedure that is an accepted procedure performed >for a medical indication performed for the purpose of a defined benefit to >the patient is billable. > >Jim Smeltzer, MD > >At 04:17 PM 9/17/1999 -0500, you wrote: >>our faciliy in california performs both endovag and transabdominal >>procedures with pelvic ultrasound exams. does anyone know if we are >>allowed to bill insurances(including M-Cal and M-Care) for both >>procedures and/or will they cover? any insight would help. >> >>thanks. >> >>-- >>sergio hernandez, rdms -- Next message: Dave Berck: "Re: Hiccup in BPP" Previous message: Lori Green: "Fetal Heart Webinar: Educational Opportunity"

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