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Insurance/Trimester question

Joe Posted Tue 15th of November, 2011 17:51:29 PM

I know that insurance companies allow 1 ultrasound during pregnancy. However, I noticed that a lot of Estimated fetal Weight request and BPP come through around the 3rd trimester and the code to report it is 76816 (which is for followup)... This would be for previous abnormal findings or problems correct? Is it normal to get an ultrasound per trimester? What V code category should I use? V28? Thanks

SuperCoder Answered Tue 15th of November, 2011 21:39:15 PM

CPT code 76816, Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed to be abnormal on a previous scan), transabdominal approach, per fetus, should be reported once for each fetus that requires re-evaluation. The same code is reported for each fetus that received the follow-up exam using Modifier 59, Distinct Procedural Service, for each subsequent fetus, after the first. This examination is designed to reassess fetal size and interval growth, or to re-evaluate one or more anatomic abnormalities of a fetus that was previously identified on an ultrasound.
Additional questions to be answered shortly.

Joe Posted Wed 30th of November, 2011 16:23:35 PM

What V code should I use to report BPP exam?

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