January Details of the fee code revisions can be found highlighted in Schedule A, attached.
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1 Government of Newfoundland and Labrador Department of Health and Community Services January TO: RE: ALL FEE-FOR-SERVICE PHYSICIANS CHANGES TO DOPPLER ULTRASOUND FEE CODES The Department of Health and Community Services (HCS), in consultation with the Newfoundland and Labrador Medical Association (NLMA), has modified fee codes under the Radiology Services Listings section of the Medical Care Plan (MCP) Medical Payment Schedule; specifically, those pertaining to Diagnostic Ultrasound. The changes have been highlighted in the schedule attached, and include the introduction of new fee codes specific to defined regions of the body, as well as modifications to existing fee codes. The revisions better reflect current practices, and provide clarity regarding how and when fee codes can be billed for certain services. These changes are effective as of October 1, Details of the fee code revisions can be found highlighted in Schedule A, attached. Questions relating to the content of this Newsletter should be directed to Andrew Wells, Director of Physician Services (Acting), Department of Health and Community Services at (709) , or by at P.O. Box 5000, Grand Falls-Windsor, NL, Canada A2A 2Y4 t f
2 Schedule A Revisions to Doppler Ultrasound Fee Codes October, 2017
3 DIAGNOSTIC ULTRASOUND Procedure codes indicated as IC must be billed IC indicating why the procedure had to be done by the Radiologist. See item 11.4 of the Preamble. Notes: 1. A-mode - Implies a one-dimensional ultrasonic measurement procedure. 2. M-mode - Implies a one-dimensional ultrasonic measurement procedure with movement of the trace to record amplitude and velocity of moving echo-producing structures. 3. Scan B-mode- Implies a two-dimensional ultrasonic scanning procedure with a twodimensional display. Doppler Studies: The Doppler fee codes listed in this section may be billed in combination with diagnostic ultrasound fee codes when a Doppler study is medically necessary and aids in the clinical decision making process. The written report must include a description of the findings when a Doppler fee code is billed. The use of Doppler for screening without a specific indication is not billable. General Ultrasound control of a procedure, done by another physician, per ¼ hour or part thereof (IC) required indicating the name of the procedure, the physician who did the procedure and the amount of time involved) Head and Neck Echoencephalography - midline, A-mode interpretation procedure (IC) Complete (midline and ventricular size) interpretation procedure (IC) Echography - ophthalmic Quantitative, A-mode interpretation procedure (IC) B-scan immersion interpretation procedure (IC) B-scan contact interpretation procedure (IC) Biometry (axial length - A-mode) interpretation procedure (IC) Foreign body localization interpretation... IC procedure (IC) Echography - neck (e.g., thyroid, neck mass or other pathology including A and/or B scans) interpretation procedure (IC) Doppler evaluation of neck pathology, one or more, uni- or bilateral add to Neonatal/paediatric cranial scan - complete interpretation procedure (IC)
4 Neonatal/paediatric spinal scan - complete interpretation procedure (IC) Heart/Major Blood Vessel Echography, pericardial effusion, M-mode interpretation procedure (IC) Ultrasound pericardiocentesis procedure and interpretation Echocardiography Complete study - 1 dimension interpretation procedure (IC) Heart/Major Blood Vessel Complete study - 2 dimensions interpretation procedure (IC) and 2 dimension study on same patient visit interpretation procedure (IC) Limited study 1 or 2 dimensions for follow-up studies interpretation procedure (IC) Doppler echocardiography interpretation procedure (IC) Aorta only interpretation procedure (IC) Vena cava only interpretation procedure (IC) Peripheral Vascular System Extra-cranial vessel assessment above the aortic arch (bilateral, carotid and/or subclavian and/or vertebral arteries only) Doppler scan or B scan frequency/spectral analysis frequency/spectral analysis with Doppler scan duplex scan, i.e. simultaneous real time, B-mode imaging and frequency /spectral analysis Note: Only one of fee codes 72240, 72241, and can be billed per patient per day. Duplex Doppler assessment of hepatic and portal venous systems interpretation procedure Note: Fee code should only be billed in cases where hepatic and portal vessels are analyzed and should include a colour study of both systems and duplex study of at least one of the two systems.
5 Post-operative organ transplant arterial and/or venous Doppler assessment (assessment of the vascularity to the organ transplant rather than the ultrasound examination of the organ itself) interpretation procedure Transcranial Doppler assessment interpretation procedure Peripheral artery evaluation distal to inguinal ligament or axilla (not to be billed routinely with 72241, or 72243) Doppler scan or B-scan frequency/spectral analysis with Doppler scan duplex scan, i.e. simultaneous real time, B-mode imaging and frequency/spectral analysis Notes: The following fee code combinations are not billable: with and with either of or Venous evaluation - duplex scan i.e. simultaneous real time, B-mode imaging interpretation procedure Duplex Doppler assessment of post-operative shunts interpretation procedure Doppler assessment of one or more intra-abdominal and pelvic vessels, uni- or bilateral interpretation procedure Notes: 1. Doppler evaluation of intra-abdominal and pelvic vessels should not be performed routinely; it should be limited to investigation of problems where the result will influence management. Examples of acceptable uses for MCP billing purposes include: a) placement of colour Doppler upon kidneys to assess for twinkle artifact if the presence of small stones is suspected; b )assessment for ureteric jets if reduced or obstructed flow is suspected; c) evaluation of a solid lesion which may be malignant; d) evaluation of a septated cyst which may be malignant; e) evaluation of vessels where stenosis or occlusion is suspected; 2. The use of Doppler to distinguish the common bile duct from a vessel is not billable. 3. Fee code and are not to be billed for screening purposes; they should be billed for problem solving purposes. 4. A maximum of one unit of fee code is payable per patient session. 5. A maximum of one unit of fee code is payable per patient session.
6 Thorax Chest masses, pleural effusion - A and B-mode interpretation procedure (IC) Ultrasonic thoracentesis procedure and interpretation Breast masses - scan B-mode (per breast) interpretation procedure (IC) Doppler evaluation of breast masses, one or more, uni- or bilateral add Abdomen and Retroperitoneum Abdominal scan, major (includes multiple organs and/or spaces) interpretation procedure (IC) Abdominal scan, limited (e.g. single organ or follow-up study) interpretation procedure (IC) Scrotum/Penis (includes Doppler examination) Testicular (1 or both) penile and scrotal scanning interpretation procedure (IC) Doppler evaluation of testicular flow when indicated, uni-or bilateral and/or evaluation of testicular/scrotal masses, one or more, uni-or bilateral...add to Obstetrics, Gynecology and Pelvis Echography - Scan B-mode Early pregnancy diagnosis interpretation procedure (IC) Foetal age determination interpretation procedure (IC) Placenta localization interpretation procedure (IC) IUCD localization interpretation procedure (IC) Pregnancy, complete interpretation procedure (IC) Foetal assessment in - utero for physical condition of the fetus (requested by the specialist) interpretation and procedure Pelvic mass interpretation procedure (IC) Endocavitary Scan interpretation procedure Transvaginal sonohysterography, includes procedure, interpretation and introduction of saline or other intracavitary contrast media Ultrasonic amniocentesis interpretation and procedure
7 Doppler assessment of one or more fetal vessels including umbilical artery and vein interpretation procedure Extremities, including Doppler examination of soft tissue mass Extremities, per limb (excluding vascular study) interpretation procedure (IC) Scan of popliteal space interpretation procedure (IC) Soft tissue mass, other than neck or limb (with or without Doppler examination) Interpretation - single mass Interpretation each additional mass (maximum of 2 units payable); add Procedure per patient session, any number of masses (IC) THERAPEUTIC ULTRASOUND Occlusion of femoral or brachial pseudo-aneurysm under colour Doppler ultrasound guidance
April 1, 2009 RADIOLOGY GENERAL RADIOLOGY G-1
GENERAL Head and Neck 70100 Skull - routine (includes Towne s views)... 13.53 70101 Sella turcica... 6.77 70110 Facial bones... 10.84 70111 Nose... 6.77 70112 Mandible... 8.13 70113 Temperomandibular joints...
Radiological / Imaging Services Fee Schedule Provider Specialty 093
CODE MOD Description 70250 TC RADIOLOGIC EXAM SKULL $18.30 $18.30 7/1/2012 71010 TC RADIOLOGIC EXAM, CHEST $11.41 $11.41 7/1/2012 71020 TC RADILOGICAL EXAM CHEST TWO VIEWS FRONTAL/LATERAL $15.76 $15.76
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