Implementation of a novel point-of-care ultrasound billing and reimbursement program: fiscal impact

Trends in Medical Claims and Utilization of Limited Ultrasonography Among Emergency Physicians and Radiologists Within a Large Health Plan Provider

“…Although limited ultrasound use has been increasing among ED providers, previous research suggests that billing for such studies in the ED is infrequent . Given this discrepancy, this study aimed to characterize recent trends in medical claim submissions during ED encounters, particularly among ED providers in comparison with radiologists, who often otherwise perform such studies.…”

“…Understanding reimbursement for point‐of‐care ultrasound studies is particularly important, given the recent growth of this modality, coupled with the considerable ongoing expenses required to establish and maintain an ultrasound program. Previous studies have focused on the fiscal impact of point‐of‐care ultrasound implementation in the ED, with contradictory results . An analysis of data from the Centers for Medicare & Medicaid fee schedule indicated that it would take approximately 5 years to break even with initial return on investment for implementing point‐of‐care ultrasound in the ED .…”

Point‐of‐Care Ultrasound Work Flow Innovation: Impact on Documentation and Billing

“…Faculty compliance with image retention, documentation, and billing requests is crucial for generating revenue from point‐of‐care US . Emergency physicians have been shown to have 9.7 work flow interruptions per hour compared to 3.9 for primary care physicians .…”

“…These challenges led to multiple attempts to improve US examination documentation for more than 2 decades, each with substantial work flow limitations. Due to the complexity and inefficiency of these archiving and documentation methods (DVD, USB, thermal prints, and spreadsheets), point‐of‐care US documentation and billing were frequently insufficient or entirely absent . These issues also contributed to downstream concerns for assessing a clinician's procedural and interpretative skill without direct observation.…”

Novel Use of Ultrasound to Teach Reproductive System Physical Examination Skills and Pelvic Anatomy

“…Thus, there is a need for medical school educators to create novel teaching modalities for students to acquire the anatomic knowledge necessary for competency and confidence in these physical examination skills. A bedside US examination is a valuable diagnostic tool for constructing differential diagnoses in many clinical specialties . In medical education, it has the advantage of showing medical students a dynamic view of the living anatomy that they will have seen in their study of anatomic prosections and dissections.…”