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

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.

Keywords

neonate - point-of-care ultrasound - billing - reimbursement - ICD codes - CPT Codes

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.

Publication History

Received: 22 February 2024

Accepted: 28 March 2024

Article published online:
02 May 2024

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