According to Medicare the only way to charge for the use of ultra sound is if you have the camera attachment and a picture is taken during the process. Medicare reimbursement is around $25-$50 depending on location and size of facility.
Is anyone charging for ultrasound when inserting PICCs? I understand that there has to be an image printed to do this charge.
BUT I have been told that nurses can't use this charge, because it would be Medicare fraud. This discussion included that it could be charged if a doctor used ultrasound and it wouldn't be Medicare fraud.
Trying to find the reference on the Medicare (CMS) site is impossible. My hair would be gray by the time I found it there.
Ultrasound has a technical component regardless of who uses it. You can charge for it. Need a picture. However bad news for Medicare it does not matter if the janitor places the PICC line there is no reimbursement on an inpatient at all as it is part of the DRG. If the facility above is gettimg $50.00 for a Medicare patient on a DRG please let us know how to capture that. For outpatients I also have bad news for Medicare. It is considered bundled into the outpatient placement for the hospital. But I would charge as not everyone is Medicare/Medicaid. It is likely 30% of your payer mix is commercial. Also it gives you a paper trail for your department to get part of the overall DRG funds. Now if you were an MD, PA, NP you could get $16 for the professional use (not equipment) of using ultrasound.
Does anyone know the procedure code for ultrasound use? We are currently working towards an outpatient program and it would be great to know this code #. Thanks.
Beth George, CRNI, VA-BC
Nurse Clinician/Vascular Access
UAB Medicine
Birmingham, AL
Is anyone charging for ultrasound when inserting PICCs? I understand that there has to be an image printed to do this charge.
BUT I have been told that nurses can't use this charge, because it would be Medicare fraud. This discussion included that it could be charged if a doctor used ultrasound and it wouldn't be Medicare fraud.
Trying to find the reference on the Medicare (CMS) site is impossible. My hair would be gray by the time I found it there.
Any help is appreciated.
Gwen Irwin
Austin, Texas
Ultrasound has a technical component regardless of who uses it. You can charge for it. Need a picture. However bad news for Medicare it does not matter if the janitor places the PICC line there is no reimbursement on an inpatient at all as it is part of the DRG. If the facility above is gettimg $50.00 for a Medicare patient on a DRG please let us know how to capture that. For outpatients I also have bad news for Medicare. It is considered bundled into the outpatient placement for the hospital. But I would charge as not everyone is Medicare/Medicaid. It is likely 30% of your payer mix is commercial. Also it gives you a paper trail for your department to get part of the overall DRG funds. Now if you were an MD, PA, NP you could get $16 for the professional use (not equipment) of using ultrasound.
Kathy Kokotis
Bard Access Systems
Does anyone know the procedure code for ultrasound use? We are currently working towards an outpatient program and it would be great to know this code #. Thanks.
Beth George, CRNI, VA-BC
Nurse Clinician/Vascular Access
UAB Medicine
Birmingham, AL