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Ob-Gyn Coding Alert

You Be the Coder:

Fetus Screening

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: One of our ob-gyns routinely scans his 11-to 14-week fetuses for nuchal translucency thickness. We have been reporting this with 76815. What would be an appropriate diagnosis code for this procedure if there are no complications with the pregnancy? Texas Subscriber

Answer: The best answer is to report V28.8 (Other specified antenatal screening) with 76815 (Ultrasound, pregnant uterus, real time with image documentation, limited [e.g., fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume], one or more fetuses). You should use V28.8 anytime the physician performs a screening ultrasound in the absence of known problems. You may be tempted to use V28.3 (Screening for malformation using ultrasonics). But you shouldn't, because this code stipulates screening for malformation. The ob-gyn is examining the nuchal transparency to assess the risk for Down's syndrome, which is a chromosomal disorder.  

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