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First Trimester Ultrasounds

Misty Posted Wed 20th of June, 2018 20:26:25 PM
My providers are struggling with first trimester ultrasounds and getting reimbursed. If a patient comes in with bleeding the provider will order an ultrasound to see if it is a viable pregnancy. The patient comes back in two weeks later same symptoms heavy bleeding, provider does another ultrasound to check for viable pregnancy. We are having diffculty getting paid for 2 ultrasounds in the first trimester. Could you please advise? Thank you Cindy
SuperCoder Answered Thu 21st of June, 2018 03:09:55 AM


Thanks for your query. We found no guideline regarding payment of multiple ultrasounds in first trimester. There are situations when multiple ultrasounds may be required and hence these should be paid by the payer. First thing to do is to map appropriate ICD-10 CM codes with CPT codes to support necessity of multiple ultrasounds.

Please see below some of the additional ICD-10 CM codes that can be mapped:

O09.891-Supervision of other high risk pregnancies, first trimester
O09.91-Supervision of high risk pregnancy, unspecified, first trimester
O26.851-Spotting complicating pregnancy, first trimester
O20.0-Threatened abortion
O20.8-Other hemorrhage in early pregnancy
O20.9-Hemorrhage in early pregnancy, unspecified

Please let us know if you still face any problem regarding payment. Also please let us know the reason of denial.


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