Download our special report on proper billing methods

This report covers how you should be billing for your ultrasounds and provides some great tips for making your ultrasound images and reports bullet-proof.

What makes your billing bullet-proof?

  • Billing out only for reasonable, justifiable ultrasound procedures.
  • Billing out with the proper codes.
  • Documenting your ultrasound images and procedures with quality images properly annotated, accompanied by quality reports.
  • Maintain impeccable image and report archives.

Study the recommendations in the report linked below and you should be positioned in the top 5% of your profession in terms of ultrasound billing and documentation.

Click here to download the PDF file of our special report on Podiatry Ultrasound Billing.

(You may be able to simply click the link above. It may open up in a separate window, or it may download to your computer, depending on your computer’s settings. If that doesn’t work for you, right-click the link and choose "Save target as" or "Save file as"and save the file to your desktop.)



A few additional words on billing for guided injections …

My suggestion when it comes to insurance billing (as always) is to try to fly under the radar as much as possible and use ultrasound to guide only the injections where you really think it aids in your accuracy. I am not a doctor, and I am not an insurance specialist, but if it were me, and I had an average-sized practice … I think I would probably keep my ultrasound-guided injections down to 2 or 3 (maybe 4) per day, and those in situations where it seems reasonably justified.

You certainly want to use your ultrasound for guiding injections. But you want to be responsible when it comes to how often you do so. A conservative approach to the number of guided injections you bill out for will prove less apt to throw up any red flags, and if you only use the ultrasound to guide select injections, and your images are well-annotated and your reports sound, you should not have anything to worry about.

Some situations seem perfect for ultrasound guidance: stump neuromas, biopsies of deep masses and abscesses, injections to a tendon sheath, and cases involving the aspiration of a fluid-filled mass not fully palpable. But this isn’t to say that other procedures might not also benefit from ultrasound guidance. Two such instances are mentioned often by our clients:

When treating Calcaneal Bursitis, ultrasound-guided pinpoint trigger injections just below the calcaneal tuberocity can thicken up the bursae, and a procedure such as this is common in many practices.

A series of plantar fascia injections might also benefit from ultrasound guidance, depending on the patient and the treatment being provided. (Indeed, there is even an article in support of one such procedure, recently published by ScienceDaily.)

In the end you must use your discretion and make use of ultrasound in guiding those injections where you think it appropriate and fit. In general, however, it’s almost always best to err on the side of caution. Better to bill out fewer guided injections and throw up no red flags … than to bill out too many and draw unneeded attention from an insurance provider.

And two final notes …

One common question that comes up concerns whether, when billing for an ultrasound-guided injection, you should bill out the exam code AND the guided injection code, or just one or the other. The best answer I have is: one or the other, not both. Not on the same day on the same foot. In other words, it would be hard to justify examining a neuroma (and billing out for that), and then using the ultrasound to guide the injection of the neuroma (and billing out for that as well). I think it is assumed that if you are guiding the injection with ultrasound, you are simultaneously viewing whatever it is you are injecting, making the two codes mutually exclusive. This is my understanding of it.

Another question that comes up has to do with whether to bill for a ultrasound-guided procedure in place of or in addition to what you charge for the actual injection itself. My understanding of this is that it is standard to bill for the injection and the ultrasound-guided procedure, in combination. In other words, to charge for both.