SCCM Resource Library-Coding Ultrasonography in Critical Care

Pdf Summary

The document focuses on the use of bedside-focused ultrasonography as a standard care practice in critical care medicine. It outlines the various applications of ultrasound, such as detecting hemorrhage and other fluids in body cavities, assisting with central venous access device placement, and evaluating focused volume status, cardiac function, and pulmonary health.<br /><br />The document explains the coding and billing processes for ultrasonic procedures in intensive care units (ICUs) using the Current Procedural Terminology (CPT) codes. CPT radiology codes are categorized into diagnostic codes (specific examinations like pleural or abdominal ultrasonic evaluations) and procedure guidance. For billing, the codes have two components: the professional (physician work) and the technical (equipment and facility costs). Physicians must append modifier 26 for the professional component when billing. The document stresses the importance of proper documentation, including medical necessity, image retention, and accurate coding, for the prevention of claim denials.<br /><br />Bedside limited ultrasonic studies for volume status evaluations employ specific protocols, although unique CPT codes for these evaluations do not exist. FAST (focused assessment with sonography in trauma) examinations are either limited or complete, depending on the extensiveness of the evaluation. Repeat examinations necessitate proper use of modifiers to indicate repetition by the same or a different physician.<br /><br />Two critical care examples illustrate practical applications and the associated CPT codes necessary for accurate billing. The document further mentions the importance of maintaining permanent image records and written interpretations to support diagnostic scans.<br /><br />It concludes with references to training opportunities for ultrasonography skills in critical care. The Society of Critical Care Medicine offers courses to enhance point-of-care ultrasound proficiency, addressing both adult and pediatric settings.

Asset Subtitle

Administration, Procedures, 2023, 09:58:00

Asset Caption

"This article was first published in the Winter 2023 issue of Critical Connections.

Bedside focused ultrasonography is increasingly becoming part of the standard of care in critical care medicine. Current Procedural Terminology radiology codes, including those for ultrasonic procedures performed at the bedside in ICUs, are divided into diagnostic codes and procedure guidance.

Critical Connections, the critical care industry's only magazine, provides information on cutting-edge topics in critical care useful to the entire multiprofessional team."

Meta Tag

Content Type Article

Knowledge Area Administration

Knowledge Area Procedures

Knowledge Level Intermediate

Knowledge Level Advanced

Learning Pathway Billing and Documentation

Membership Level Associate

Membership Level Professional

Membership Level Select

Tag Ultrasound

Tag Administration

Year 2023

Keywords

Billing and Documentation

bedside ultrasonography

critical care medicine

ultrasound applications

CPT coding

billing processes

central venous access

volume status evaluation

FAST examination

image documentation

ultrasound training

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