Am J Perinatol 2024; 41(14): 2014-2020
DOI: 10.1055/s-0044-1786721
Clinical Opinion

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

1   Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, Utah
,
Natalie Mnyavanu
2   Department of Quality Assurance, University Medical Billing, Salt Lake City, Utah
,
Shazia Bhombal
3   Department of Pediatrics, Emory University/Children's Healthcare of Atlanta, Atlanta, Georgia
,
María V. Fraga
4   Division of Neonatology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
,
Alan M. Groves
5   Division of Neonatology, Department of Pediatrics, University of Texas at Austin Dell Medical School, Austin, Texas
,
Stephanie Marshall
6   Division of Neonatology, Department of Pediatrics, Ann & Robert H Lurie Children's Hospital, Feinberg School of Medicine at Northwestern University, Chicago, Illinois
,
Shanmukha Mukthapuram
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
,
on behalf of the members of National Neonatal POCUS Collaborative › Institutsangaben
Funding None.

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

  • Code neonatal POCUS procedure precisely allows accurate reimbursement and reduced errors in billing.

  • Document details to support medical necessity and reimbursement claims effectively.

  • Adhere to regulations to avoid audits, denials, and ensure proper reimbursement.

Authors' Contributions

B.C. and Y.S. contributed equally to the concept design, research, writing, and editing of the manuscript. The others contributed to the editing of the manuscript.




Publikationsverlauf

Eingereicht: 22. Februar 2024

Angenommen: 28. März 2024

Artikel online veröffentlicht:
02. Mai 2024

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