tci Medicare Compliance & Reimbursement - 2014 Issue 12

Reader Question: Place of Service Guides Ultrasound Coding for Epidural Placement

Question: Is it feasible to use ultrasound rather than fluoroscopy for guidance when inserting a lumbar epidural catheter for post operative pain? If so, can the ultrasound be submitted to the carrier? Which codes would apply? Answer: Medicare reimburses for ultrasound services when the services are within the scope of the provider’s license and are deemed medically necessary. It is entirely up to the physician to choose which imaging services are required in a particular situation. Office services: In the office setting, a physician who owns the equipment and performs the ultrasound guidance may report the global/non-facility code...

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