Billing and Coding: Nonvascular Extremity Ultrasound

Nonvascular extremity ultrasound is covered when medical necessity is documented in the record (relevant history, physical exam, and pertinent diagnostic test results) and the claim includes ICD-10-CM codes that describe the condition; for services requiring a referring physician, the referring physician's name and NPI must be reported. Providers must keep a permanent record with labeled images, measurements, and formal interpretation, share results with the referring physician, and make documentation available to Medicare; coding edits (NCCI/OPPS) may apply. Services exceeding two tests per extremity within six months are considered not medically necessary and claims without ICD-10-CM codes will be returned.

"Nonvascular extremity ultrasound is covered when medical necessity is documented in the patient's record, including relevant medical history, physical examination, and results of pertinent diagnost..."