An ultrasound is a commonly used medical imaging procedure that can help to evaluate various parts of the body. These scans utilize high-frequency sound waves that create images and be interpreted so that providers can visualize the internal structures in the body. This can help doctors assess the source of pain, find areas of swelling, locate infections and tumors, examine internal organs, evaluate fetal growth in a mother, visualize blood flow directionality and speed, and much more. In many cases, Medicare benefits will cover the costs of these imaging tests as long as they are deemed medically necessary by their physician.
What is an Ultrasound?
Ultrasounds are widely used in medicine and are very safe, non-invasive procedures. An ultrasound is performed by a sonographer, who is specially trained to obtain the images so that they can be read by radiologists, cardiologists, or other specialists depending on the reason for the test.
The sonographer uses a transducer, which is a hand-held device that can come in a variety of shapes and sizes. The transducer is placed directly on the patient’s skin. Ultrasound gel is also used as it helps to create a link between the transducer and the skin. The transducer creates sound waves, which are unable to travel well through air. The use of gel helps to eliminate empty space and improve the quality of the images created by the scan.
The word “ultrasound” refers to the sound waves being at such a high frequency that humans are unable to hear them. The typical human hearing range is most sensitive from around 2,000 to 5,000 hertz and can technically extend from 20 to 20,000 hertz. Ultrasound produces waves far above this range at between two million and 18 million hertz.
The higher frequency waves are able to provide a clearer image but are not able to penetrate as deeply into the skin and other tissues. On the other hand, lower frequency waves can provide images of tissues deeper in the body, but they will not be as high in quality.
As the sound waves travel through the body, they will bounce back once they hit a certain type of tissue. For example, in the heart, the sound waves are able to travel through the blood unimpeded, but once they hit a heart valve, they will bounce back. The denser the object or tissue, the more bounce back that occurs. This causes tissues of different densities to show up as varying shades of gray on the image.
Medicare Coverage for an Ultrasound
Medicare benefits will often cover ultrasound tests as long as they are ordered by the physician and are being used for a medically-necessary reason. These tests may be covered if they are being used to diagnose a specific health condition, rule out a possible condition or illness, or examine and screen the body for a potential medical issue.
If you are in need of an ultrasound as a part or result of an inpatient procedure or other incident and you are staying in the hospital or in a skilled nursing facility at the time of the test, Medicare Part A will provide coverage for the ultrasound. Part A covers inpatient medical expenses, and you will be required to pay your premium payment, if you have one, and the full amount out of pocket until you hit your deductible.
Obtaining an ultrasound in an outpatient facility is covered by Medicare Part B. Part B helps to cover outpatient care, supplies, and preventive services for Medicare recipients. When using Part B, you will be responsible for paying your premium payment, any remaining balance of your deductible, and 20 percent of the Medicare-approved amount for the ultrasound.
Ultrasounds are a highly valuable tool that can be used for a variety of medical purposes. These non-invasive tests can help to diagnose or rule out potential medical issues and conditions, allowing physicians to treat their patients more effectively.