AMA calls for reimbursement for all ultrasound exams

The House of Delegates of the American Medical Association (AMA) has gone on record in support of paying adequately trained doctors for sonographic services, even if the exams are not provided by a radiologist.

"We felt it was necessary to approve this resolution because we found out that there are some insurance companies that aren't paying doctors for sonographic service, claiming that only radiologists are qualified to perform that function," said Dr. LaMar McGinnis, a general surgeon from Atlanta and an AMA delegate representing the Chicago-based American College of Surgeons.

The resolution, discussed at the AMA House of Delegates meeting in Chicago last month, affirmed that "ultrasound imaging is within the scope of practice of appropriately trained physicians, and that criteria for granting privileges for performing ultrasound procedures should be based on recommended training and education standards developed by each physician's respective specialty."

McGinnis said that when ultrasound technology first came on the scene a generation ago, radiologists were the primary operators. However, ultrasound is now an integral part of image-guided surgery.

"For a great many doctors, sonography has replaced the stethoscope for diagnosis in gynecology, gastroenterology, surgery, and many other fields," he said. The American College of Surgeons introduced the resolution because of reports from doctors that they were being turned down for reimbursement by insurers.

"Some of these doctors, who were denied reimbursement because they weren't radiologists, are experts in the use of sonography who travel around the world instructing other doctors in the proper use of the devices," McGinnis said.

The resolution noted that the payment exclusions "serve to limit patient access to state-of-the-art techniques used by physicians who are best-trained to treat the patient’s specific medical problems."

The resolution, which was unanimously approved by the House of Delegates, asks that the "AMA, in collaboration with other specialty societies, vigorously advocate with Medicare and other payors that all appropriately trained physicians -- regardless of specialty -- be reimbursed for performing diagnostic sonography, including sonographically directed biopsy, aspiration, etc., in situations with defined clinical indications."

By Edward Susman
AuntMinnie.com contributing writer
July 11, 2002

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