Essentials of Point-of-Care Ultrasound Coding and Billing at the Neonatal Intensive Care Unit Setting in the United States

Author:

Chan Belinda1ORCID,Mnyavanu Natalie2,Bhombal Shazia3,Fraga María V.4,Groves Alan M.5,Marshall Stephanie6,Mukthapuram Shanmukha7,Singh Yogen8ORCID,

Affiliation:

1. Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, Utah

2. Department of Quality Assurance, University Medical Billing, Salt Lake City, Utah

3. Department of Pediatrics, Emory University/Children's Healthcare of Atlanta, Atlanta, Georgia

4. Division of Neonatology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania

5. Division of Neonatology, Department of Pediatrics, University of Texas at Austin Dell Medical School, Austin, Texas

6. Division of Neonatology, Department of Pediatrics, Ann & Robert H Lurie Children's Hospital, Feinberg School of Medicine at Northwestern University, Chicago, Illinois

7. Department of Neonatology, Envision Physician Services, Wellington Regional Medical Center, Wellington, Florida

8. Division of Neonatology, Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda University Children's Hospital, California

Abstract

Point-of-care ultrasound (POCUS) has increasingly been used by neonatal providers in neonatal intensive care units in the United States. However, there is a lack of literature addressing the complexities of POCUS coding and billing practices in the United States. This article describes the coding terminology and billing process especially those relevant to neonatal POCUS. We elucidate considerations for neonatal POCUS billing framework and workflow integration. Directions on image storage and supporting documentation to facilitate efficient reimbursement, compliance with billing regulations, and appeal to insurance claim denial are discussed. Key Points

Publisher

Georg Thieme Verlag KG

Reference18 articles.

1. International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC);Y Singh;Crit Care,2020

2. The Committee on Fetus and Newborn and Section on Radiology, Section on Radiology Executive Committee, 2021–2022. Use of point-of-care ultrasonography in the NICU for diagnostic and procedural purposes;D L Stewart;Pediatrics,2022

3. Use of point-of-care ultrasonography in the NICU for diagnostic and procedural purposes;D L Stewart;Pediatrics,2022

4. Implementation of a novel point-of-care ultrasound billing and reimbursement program: fiscal impact;S Adhikari;Am J Emerg Med,2014

5. A workflow task force affects emergency physician compliance for point-of-care ultrasound documentation and billing;R E Lewiss;Crit Ultrasound J,2016

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