OBJECTIVE: The purpose of this study was to determine the cost considerations and strategies for incorporating ultrasound (US) in a head and neck practice.
STUDY DESIGN AND SETTING: A retrospective chart review of office-based US procedures from 2001 to 2005 was completed at our academic medical center. Billing and coding for US and US guided fine needle aspiration (USFNA) were examined.
RESULTS: The appropriate CPT codes are 76536 for US and 76942 and 10022 for USFNA-related procedures. The USFNA codes should be used repeatedly for correct coding of biopsies from multiple sites. Cost (equipment) sharing between specialties is a potential strategy for office-based US incorporation.
CONCLUSION: Based on practice volume, specific CPT coding, and Medicare reimbursements, office-based US equipment and certification costs could be offset in 1 year.
SIGNIFICANCE: Office-based US can be readily incorporated with significant benefits to patients. Billing and usage strategies were identified that would improve the economics of providing office-based US.
Get full access to this article
View all access options for this article.
References
1.
AlbericoRAHusainSHSirotkinI.Imaging in head and neck oncology. Surg Oncol Clin N Am2004;13:13–35.
2.
ThomsenJBSorensenJAGrupeP, et al. Staging N0 oral cancer: lymphoscintigraphy and conventional imaging. Acta Radiol2005; 46: 492–6.
3.
CrespoANChoneCTFonsecaAS, et al. Clinical versus computed tomography evaluation in the diagnosis and management of deep neck infection. Sao Paulo Med J2004;122:259–63.
4.
SilvermanPM.Lymph node imaging: multidetector CT (MDCT). Cancer Imaging2005;5(Suppl):S57–67.
5.
AtulaTSVarpulaMJKurkiTJ, et al. Assessment of cervical lymph node status in head and neck cancer patients: palpation, computed tomography, and low field magnetic resonance imaging compared with ultrasound-guided fine-needle aspiration cytology. Eur J Radiol1997; 25:152–61.
6.
Baatenburg deJong RJRongenRJLamerisJS, et al. Metastatic neck disease: palpation vs ultrasound examination. Arch Otolaryngol Head Neck Surg1989;115:689–90.
7.
HaberalICelikHGocmenH, et al. Which is important in the evaluation of metastatic lymph nodes in head and neck cancer: palpation, ultrasonography, or computed tomography?Otolaryngol Head Neck Surg2004;130:197–201.
8.
BelldegrunAKimHLandmanJ, et al. Intraoperative ultrasonography in urologic oncology. Urol Oncol2004;22:153–5.
9.
HarlowSP.Another role for ultrasonography in the management of breast cancer. Ann Surg Oncol2006;13:1–2.
10.
FalconiMBettiniRBoninsegnaL, et al. Surgical strategy in the treatment of pancreatic neuroendocrine tumors. JOP2006;7:150–6.
11.
Sciaky-TamirYCohenSMHochner-CelnikierD, et al. Three-dimensional power Doppler (3DPD) ultrasound in the diagnosis and follow-up of fetal vascular anomalies. Am J Obstet Gynecol2006; 194: 274–81.
12.
ChoudhurySRRajivCPitamberS, et al. Management of splenic abscess in children by percutaneous drainage. J Pediatr Surg2006; 41: 53–6.
13.
GluckmanJL MWPortugalLGWelkoborskyHJ.Real-time ultrasonography in the otolaryngology office setting. Am J Otolaryngol1993;14:307–13.
14.
van den BrekelMWStelHVCastelijnsJA, et al. Lymph node staging in patients with clinically negative neck examinations by ultrasound and ultrasound-guided aspiration cytology. Am J Surg1991;162:362–6.
15.
PhelpsPSavyLRichardsP.The future of imaging in otolaryngology. J Laryngol Otol2000;114:659–60.
CharousSJ.An overview of office-based ultrasonography: new versions of an old technology. Otolaryngol Head Neck Surg2004; 131: 1001–3.
21.
American College of Emergency Physicians (ACEP).Policy Statement (Emergency Ultrasound Guidelines). http://www.acep.org/webportal/PracticeResources/PolicyStatements/pracmgt/EmergencyUltrasoundGuidelines.htm. (June 2001).
22.
American Institute of Ultrasound in Medicine (AIUM).Training Guidelines for Physicians Who Evaluated and Interpret Ultrasound Examinations. (Approved 2003) http://www.aium.org.
