Mistaken CT Scan for needle Biopsy when only Ultra Sound Biopsy Required

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In an age where insurance companies dictate the quality and what kind of medical care we receive, it certainly makes sense to be alert to the possibilities of errors in diagnosis and over billings. A close family member with goiter was told by her primary care physician that she might need a fine needle aspiration(FNA) to help diagnose and treat her multi-nodular thyroid condition.

We registered at local hospital to have an ultra sound biopsy performed which would indicate whether the FNA was necessary. The attendant produced the estimate you see below with the anticipated service description of CT Scan for needle biopsy which would have cost us around $3300. Our Blue Cross Blue Shield would have covered $3100, so we signed on the dotted line and took her to the radiology department. Neither of us noticed the mistake, and only prior to treatment was it noticed that we only needed an ultrasound biopsy and NOT a CT Scan for needle biopsy!!

It turns out that the CPC codes for ultrasound biopsy and CT Scan for needle biopsy are close to the same and the clerk input the wrong CPC code! The hospital staff was very courteous and professional about acknowledging error and correcting the overbilling.

I have heard that sometimes the error is not caught by the doctor or patient and the wrong  procedure is done!  So, be alert people before you let them do anything to you. They usually get it right, but double-check because hospital personnel are often underpaid, in a hurry, and stressed out just like the rest of us.

CT

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6 comments on “Mistaken CT Scan for needle Biopsy when only Ultra Sound Biopsy RequiredAdd yours →

  1. Something similar happened to us at eastern New Mexico medical center in Roswell. The registrar girl or somebody typed the wrong Current Procedural Terminology (cpt) code into billing system and we were, of course, charged too much. They caught the error, but it cost us time. They definitely need a separate person to proofread or error check every time cpt code is input to avoid hassle and to increase patient confidence that medical professionals know what they are doing!
    At least I learned that cpt stands for Current Procedural Terminology.

    1. Speaking of medical mistakes, Jan D Hobbs an ENT physician is not really forthcoming about the way he bills. He spent less than 20 minutes with me and billed me almost $400. Blue Cross Blue Shield would only cover $210. The problem with a guy like Hobbs or many other doctors is that you are forced to trust him to be fair about what he charges. He could have billed me for $500 and I would not know the difference.
      Dr. Hobbs dinged his little tuning fork around my ear with a fake smile dripping off his face the whole time. Maybe he really is a nice guy, but that smile is a dollar sign grin because he knows a lot of his patients will just go ahead and pay him when he over bills. Medical overbilling is a huge problem. Do not automatically pay the bill. Call the doctor’s office ask them to be more specific and demand an itemization.

      1. Yes the ENT Hobbs is known for over billing and over prescribing drugs and narcotics. He could charge you any amount he wants.

        1. Jan Hobbs, the Ears, Nose, and Throat Specialist in Roswell is an excellent doctor, BUT he will try to bill you for what most other doctors will just write off.

          You know the game that the doctors play with the insurance companies, OVERBILL , then the insurance company might pay them half of that. What Hobbs does is collect from Blue Cross Blue Shield or whoever. THEN he will bill the patient for the part of the OVER BILLING that the insurance company refused to pay!

          Its not fair what he is doing. Like throwing a net out blindly and hoping he will catch a few fish.

          1. I am not sure how Hobbs has stayed in business so long. Not an effective communicator and lost in space much of the time. Seems to be searching for a reason to write you a prescription. Such a shortage of knowledgeable level headed physicians in Roswell,NM. My friend Vicki just adores him.

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