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Navigating Point-of-Care Reimbursement in Critical Care, Challenges and Current State

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Abstract

Purpose of Review

Point-of-care ultrasound (POCUS) use in the intensive care unit has continued to grow, year over year with more faculty having some training and many programs training fellows. This review is to help summarize recent publications related to credentialing, coding, and billing for POCUS studies.

Recent Findings

While there have not been significant changes in advice from regulatory agencies related to POCUS billing and reimbursement, there has been more guidance on training, documentation, and coding issued by different specialty organizations.

Summary

Credentialing for POCUS remains open for practitioners but is dependent on local governing bodies. Billing for POCUS studies in the Intensive Care Unit (ICU) requires documentation including retention of images, diagnosis, and report containing findings. In seeking reimbursement for POCUS in the ICU, develo** a workflow that includes all requirements can help to ensure avoid rejected claims.

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Data Availability

No datasets were generated or analysed during the current study.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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  2. American Medical Association. Privileging for ultrasound imaging H-230.960. 2020. https://policysearch.ama-assn.org/policyfinder/detail/Ultrasoundimaging?uri=%2FAMADoc%2FHOD.xml-0-1591.xml.

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  7. Society of Hospital Medicine. POCUS certificate of completion program requirements. 2023. https://www.hospitalmedicine.org/clinical-topics/ultrasound/pocus-certificate-of-completion/.

  8. American College of Chest Physicians. Point-of-care ultrasound certificate of completion. 2023. https://www.chestnet.org/learning-and-events/learning/certificate-of-completion/pocus.

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T.Y. wrote the manuscript text. All authors reviewed and edited the manuscript.

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Correspondence to Travis Yamanaka.

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Yamanaka, T., Kaul, M. & Barreras, N. Navigating Point-of-Care Reimbursement in Critical Care, Challenges and Current State. Curr Pulmonol Rep 13, 146–151 (2024). https://doi.org/10.1007/s13665-024-00347-y

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