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The Mysterious World of OB Ultrasound Coding

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The Mysterious World of OB Ultrasound Coding

CPT Code 76811 Ultrasound, pregna nt uterus, real time with image documentation, fetal an d maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation

http://static.aapc.com/a3c7c3fe-6fa1-4d67-8534-a3c9c8315fa0/16f6616f-8c79-4d59-9b97-6d29ecbaee89/2f64d6c1-d307-46b9-b8b7-4cf75bf534e2.pdf

Date added: May 29, 2012 - Views: 67

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Coding for multiple ultrasounds - CODING AND COMPLIANCE

76811 76812 Ultrasound, pregnant uterus, real tim e w ith im age docum entation, ... Cassio reported CPT code 76805 to describe the initial screening U/S (Figure 1). This code is specifi c for a transabdom inal U /S perform ed after the first trim ester and

http://www.codingandcompliance.com/news/NewsArticleFiles/MultipleUltrasounds.pdf

Date added: December 20, 2011 - Views: 68

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Ultrasound Policy Overview - MultiPlan

TXPEC-0489-12 Issued August 2012 . Ultrasound Policy Overview. What is the Amerigroup policy on prenatal ultrasounds? Members are covered for one routine prenatal ultrasound per pregnancy — CPT code 76801 or 76805.

http://www.multiplan.com/phcsmedicaid/pdf/TTC-AGP7_PU_Ultrasound.pdf

Date added: March 10, 2013 - Views: 5

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Coding In Ob Sonography - Meetingpro.info - The PLAZA Group

76811 Ultrasound, pregnant uterus, real ... – Code includes ultrasound guidance so DO NOT bill that separately! 8 76805 Basic scan 1.00 +0.01 76810 Multiple* 0.97-1.00 76815 Limited ... • ACOG “CPT Coding in Obstetrics & Gynecology ...

http://www.meetingpro.info/plaza/registrants/GoHo09/Lectures_PDF/Copel%20Coding%20Update.pdf

Date added: November 2, 2011 - Views: 26

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Obstetrical Ultrasound Coding and the Radiology Report

The most common or standard OB ultrasound study performed after the first trimester is described by CPT code 76805. The number of gestations and examination of the

http://www.acr.org/~/media/ACR/Documents/PDF/Economics/Coding%20Source/2009%20Jul%20Aug/Obstetrical%20Ultrasound%20Coding%20and%20the%20Radiology%20Report.pdf

Date added: December 19, 2013 - Views: 2

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for Maternal Fetal Medicine, Coding Committee White Paper on ...

Society for Maternal Fetal Medicine, Coding Committee White Paper on Ultrasound Code 76811 (Revised December 27, 2012) The CPT 76811 (Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal

https://old.smfm.org/attachedfiles/UltrasoundCode76811Revised-Dec272012.pdf

Date added: May 31, 2014 - Views: 1

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CPT Codes: Ultrasounds - Howard Radiology

Ultrasound Abdomen (Complete)..... 76700 Abdomen (Limited) ... OB Detailed Anatomy Survey (18-20 wks).. 76811 OB Follow up..... 76816 OB Limited ... CPT Codes: Ultrasounds T I 443.574.5800 F I 443.574.5822. Title: Layout 1

http://howardradiology.com/pdfs/Ultrasound%20CPT%20Codes.pdf

Date added: September 26, 2012 - Views: 64

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FTC Codes for Referrals (2) - UCSF Medical Center

Ultrasound - Fetal Survey CPT Codes Quantity Ultrasound - OB Complete CPT Codes Quantity Singleton - Fetus A 76811 X Singleton - Fetus A 76805 Twin Fetus - A 76811 Twin Fetus ... Fetal MRI CPT Code Quantity (For Twins or Triplets add x2 or x3) For Singleton, Twins, ...

http://fetus.ucsfmedicalcenter.org/spina_bifida/Spina%20Bifida%20Fetal%20Surgery%20FTC%20Codes.pdf

Date added: October 25, 2011 - Views: 22

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CPT Code Changes for 2014 RADIOLOGY - McKesson

CPT Code Changes for 2014 RADIOLOGY Myra Blankenship, CPC, CIRCC Cathy Woodall, CHC, CPC Nicholas Parish, CHC, CPC Compliance-Radiology McKesson Business Performance Services . 2 Overview Current Procedural Terminology (CPT) 2014 contains new and revised codes for a variety of diagnostic,

http://mptrms.mckesson.com/rs/MckessonPT/images/RAD_2014_CPT%20Code%20Changes%20FINAL.pdf

Date added: February 8, 2014 - Views: 42

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Ultrasound Exam for Pregnancy - Health Plan of Nevada

The Current Procedural Terminology (CPT) codes and HCPCS codes listed in this policy are for reference purposes only. Listing of a service code in this policy does not imply that the service ... CPT 76816 to be used for the follow up ultrasound for 76811 and 76805 when doing a focused

http://www.healthplanofnevada.com/documents/provider%20files/Ultrasound%20Exam%20for%20Pregnancy%20OBG020.pdf

Date added: January 27, 2012 - Views: 12

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Changes to Reimbursement Policies - Community Plan Homepage

diagnosis code found on the Routine OB Ultrasound allowed diagnosis code list. Reimbursement for a Detailed OB Ultrasound (CPT codes 76811 and 76812) will be allowed when submitted with a diagnosis code found on the

http://www.uhccommunityplan.com/content/dam/communityplan/healthcareprofessionals/reimbursementpolicies/UHC-ProviderBulletin-11-12.pdf

Date added: October 27, 2013 - Views: 2

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National Imaging Associates, Inc. Clinical guideline ...

CPT Codes: 76805, +76810, 76811, +76812, 76815, 76816, 76817, 76820, ... (CPT Code 76817): Routine prenatal cervical length screening by transvaginal ... ultrasound code 76811. Announcements Washington, DC: SMFM; May 24, 2004.

http://www1.radmd.com/media/523138/ob-ultrasound-guideline-2012.pdf

Date added: October 27, 2012 - Views: 31

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October 2012 2012-047 Avoid Coding Errors on Claims for ...

Terminology (CPT®) code 76811. This code is for an obstetrical ultrasound that provides an extensive analysis of the fetal anatomical elements reported in the standard obstetrical ultrasounds CPT codes 76805 and 76810. Blue Cross Medical Policy #016, ...

https://www.bcbsal.org/providers/publications/providerFacts/2012-047.pdf

Date added: November 27, 2012 - Views: 7

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OBSTETRICAL ULTRASOUND IMAGING GUIDELINES

¾ CPT code 76811 is limited to one procedure per pregnancy. o Ultrasound Codes: ... 2004.http://www.askleslie.net/rads/White_Paper_on_Ultrasound_Code_76811.pdf. Accessed September 22, 2009. OBUS-8.9 ~ Fetal Doppler ¾ Reddy UM, Filly RA, Copel JA.

http://www.ncdhhs.gov/dma/radiology/OBUltrasound.pdf

Date added: October 31, 2011 - Views: 94

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At Long Last, a CPT Change for Obstetric Sonography

Code 76801. There has long been confusion about the proper coding for the first-trimester scan. Some advocated using 76805, arguing that they were performing a “complete” scan,

http://www.jultrasoundmed.org/content/22/1/1.full.pdf

Date added: April 1, 2012 - Views: 12

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Obstetrical Ultrasonography - OXHP

Obstetrical Ultrasonography: Clinical Policy (Effective 11/01/2013) ©1996-2013, Oxford Health Plans, LLC 1 . CLINICAL POLICY . ... CPT Code 76811: will be reimbursed two times per pregnancy if billed by two different providers. If : 76811:

https://www.oxhp.com/secure/policy/obstetrical_ultrasonography.pdf

Date added: June 28, 2013 - Views: 1

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CPT Code Guidelines Ultrasound - Lake Medical Imaging

CPT Code Guidelines Ultrasound Ultrasound Abdomen 76700 Abdomen Complete Ultrasound 76705 Abdomen Limited 93975 Abdomen Doppler 76770 Aorta/Renal Retroperitoneal Complete

http://www.lakemedicalimaging.com/Domains/www.lakemedicalimaging.com/CMSFiles/Docs/CPT%20Codes/CPT%20Code%20Guidelines%20for%20Ultrasound.pdf

Date added: November 2, 2012 - Views: 33

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Payable diagnosis codes and procedure codes for various claim ...

76801, 76805, 76811, 76813, 76815-76818, 80055 136 V22-V23, V28, 640.x3 ... 654.x3, 655.x3, 656.x3, 657.x3, 658.x3, 659.x3, 678.x3, 679.x3. *For code combination approach, must include one code from (A), and one code from (B ... Payable diagnosis codes and procedure codes for various ...

http://chcmedicaid-michigan.coventryhealthcare.com/web/groups/public/@cvty_medicaid_michigan/documents/adacct/c044652.pdf

Date added: November 2, 2011 - Views: 8

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Get Familiar with New OB Ultrasound Codes

This add-on code is used with 76811 for each additional gestation. ... Use this code for a transvaginal ultrasound of pregnant uterus. ... The 2003 CPT codes contain several new codes describing obstetrical ultra-sound procedures.

http://www.hcpro.com/content/42885.pdf

Date added: November 11, 2011 - Views: 8

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Commonwealth of Massachusetts Executive Office of Health and ...

American Medical Association’s latestCurrent Procedural Terminology (CPT) code book and to the ... 76811 76812 76813. Commonwealth of Massachusetts MassHealth Provider Manual Series Subchapter Number and Title 6. Service Codes and Descriptions Page 6-3

http://www.mass.gov/eohhs/docs/masshealth/transletters-2012/chc-94.pdf

Date added: September 26, 2012 - Views: 5

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Anthem Central Region Clinical Claims Edit #300

gestation {list separately in addition to code for primary procedure). 76811 (Ultrasound, pregnant uterus, ... inappropriate interpretation of CPT code definition) code to code 76825. Therefore, if 76986 is submitted with 76825--only 76825 reimburses.

http://www.anthem.com/shared/noapplication/f3/s3/t0/pw_043143.pdf?na=custclaimsedits

Date added: May 17, 2012 - Views: 3

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HCR MPP-0208-031914 Global Maternity PymtPolicy - UHA » Home

Global Maternity Payment Policy Policy number M.OBG.04.120301, effective 12/01/2013 Page 2 3. Fetal biophysical profile (CPT code 76818, 76819)

https://uhahealth.com/uploads/forms/form_obg_global-maternity.pdf

Date added: February 12, 2014 - Views: 1

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MRI - HCA VA Outpatient Imaging

CPT Code Reference Sheet Not all studies are performed at each location CPT CODES—HCA VA OP IMAGING Appomattox Imaging (804) 524-2340 Buford Road Imaging ... 76536 US Thyroid, Soft Tissue of Head & Neck 76811 US OB Complete Single

http://www.hcavaopimaging.com/wp-content/uploads/2010/11/CPT-Code-Reference-Sheet-4-2012.pdf

Date added: October 22, 2012 - Views: 18

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Basic Versus Detailed Sonography - Journal of Ultrasound

The CPT code 76811 describes an examination including the compo-nents of the basic examination as well as detailed anatomic evaluation of the fetal brain, ventricles, face, heart, outflow tracts, chest anatomy, specific abdominal

http://www.jultrasoundmed.org/content/28/8/1015.full.pdf

Date added: June 17, 2013 - Views: 5

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Your Physician Based Billing? Missing a Revenue Opportunity ...

± CPT Code 76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach ; single or first gestation ± CPT code 76813 Ultrasound, pregnant uterus, real

http://www.codingcert.com/wp-content/uploads/2012/05/Webinar-Handouts-OB-Ancillary-Services-Are-You-Missing-a-Revenue-Opportunity-in-your-Physician-Based-Billing1.pdf

Date added: April 21, 2013 - Views: 6

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Imaging Cpt Code Reference Sheet Studies - Hca Va ...

CPT Code Reference Sheet Not all studies are performed at each location CPT CODES—HCA VA OP IMAGING Appomattox Imaging

http://www.hcavaopimaging.com/wp-content/uploads/2011/04/CPT-Code-Reference-Sheet-_1.pdf

Date added: December 16, 2011 - Views: 96

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Provider Type 74 Billing Guide - Nevada

Provider Type 74 Billing Guide Updated: 07/11/2012 Provider Type 74 Billing Guide ... CPT code 58565 does not require prior authorization ... Non-payable if 76811 has been utilized, unless a significant 2nd diagnosis

http://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT74.pdf

Date added: May 26, 2012 - Views: 5

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Prenatal and Postpartum Care (PPC) - NCQA

Prenatal and Postpartum Care ... Part B: Any one code. CPT: 76801, 76805, 76811, 76813, 76815-76818, 80055 ICD-9 CM Diagnosis: ... Current Procedural Terminology © 2009 American Medical Association. All rights reserved. Prenatal and Postpartum Care

http://www.ncqa.org/portals/0/Prenatal%20Postpartum%20Care.pdf

Date added: December 28, 2012 - Views: 15

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Radiology Table of Contents - You are now being redirected

PHYSICIAN TYPE CPT CODE CPT DESCRIPTION Urologists 76870, 76872 76873 76942 Ultrasounds – echography, genitalia, bladder ... 76811 U/S Pregnant Uterus Fetal & Maternal Eval Plus Fetal Anatomic Eval Transabdominal Single Or First Gestation *

https://www.hipusa.com/downloads/provider_manual/12_Radiology.pdf

Date added: December 17, 2011 - Views: 15

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Peach State Health Plan OB Ultrasound Management Program ...

Peach State Health Plan OB Ultrasound Management Program Frequently Asked Questions (FAQs) ... o Providers can bill one CPT code from any two of the following three groups: 76801 or 76817 for the first trimester. 76805 or 76811 for second trimester ...

http://www1.radmd.com/media/253236/peach-state-health-plan-obus-faq.pdf

Date added: April 27, 2012 - Views: 4

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Obstetrical Services Policy - UnitedHealthcare Community Plan ...

UnitedHealthcare Community Plan reimbursement policies uses Current Procedural Terminology (CPT® ... (CPT codes 76801, 76802, 76805, 76810, 76811, 76812, 76813, 76814, 76815, 76816, 76817 ... using the non-global obstetrical codes. Code 59409 is allowed when billed by a Birthing Center on a CMS ...

http://www.uhccommunityplan.com/content/dam/communityplan/healthcareprofessionals/reimbursementpolicies/R0064-ObstetricalServicesPolicy.pdf

Date added: October 29, 2013 - Views: 1

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APPLICABLE CPT CODES FOR FETAL MONITORING

APPLICABLE CPT CODES FOR FETAL MONITORING The information about Medicare's relative value payment below represents a national average reimbursement

http://www.medicalresources.com/pdf/Nicolet-APM-APM2-CPT-Codes.pdf

Date added: March 24, 2013 - Views: 14

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IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY

AmeriChoice reimburses for trigger point injections into one to two muscles (CPT code 20552) or three to four muscles (CPT code 20553) when one of the diagnosis codes are listed on a

http://www.americhoice.com/edocs/en/physicians/policies/pdf/R0067.pdf

Date added: March 18, 2012 - Views: 2

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MODIFIER 59 ARTICLE - Centers for Medicare and Medicaid Services

Current Procedural Terminology (CPT) codes should not be reported together either in all situations or in most situations. For PTP edits that have a Correct Coding Modifier ... Modifier 59 may be reported with CPT code 75710 if a diagnostic angiography has not

http://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/Downloads/modifier59.pdf

Date added: June 21, 2012 - Views: 103

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SOS PCP OB Billing Instructions - UnitedHealthcare Community ...

Part A: Any one code: CPT code: 99201-99205, 99211-99215; UB-92 Revenue code: 514 Part B: Any one code. CPT Code ... 76811 Us, Preg Uter, Real Time W/Image Doc, Fetl & Matrnl, + Detl Fetl Exm, Transabd; Singl/1st Add'l Gest

http://www.glhp.com/LogInsert.aspx?FileAccessed=Providers/PDF/SOS/SOS_PCP_OB_Billing_Instructions.pdf

Date added: October 28, 2012 - Views: 2

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Perinatal Diagnostic Imaging - Welcome to Perinatal ...

Level II (Complete and Detailed Exam) 76811 –A very detailed exam of fetal anatomy, used when more than a screening evaluation of anatomy is desired, ... It is best to use a diagnosis code that is not a “V” code. 655.93 (suspected fetal anomaly) may be used, among others (see Appendix C).

http://www.perinatalimaging.com/Make_an_Appointment_-_Diagnosis_Codes.pdf

Date added: October 7, 2012 - Views: 2

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Adviser OBGM 0903 final - OBG Management

Are CPT 76805 and 76811 different? Both are for fetal and maternal ultrasound eval-uation, yet 76811 includes a detailed fetal anatomic exam. Our ultrasonographer says she always does a detailed fetal exam. Code 76811 (ultrasound, pregnant uterus, real time with image documentation, fetal

http://www.obgmanagement.com/fileadmin/obg_archive/pdf/1509/1509OBGM_Adviser.pdf

Date added: May 24, 2014 - Views: 2

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N.C. DMA: Diagnostic Ultrasound and Noninvasive Vascular ...

be reported with the limited retroperitoneum ultrasound code: CPT 76775. A limited retroperitoneum ultrasound (CPT 76775) can refer to a specific study of a single organ, a limited area, or a follow-up study.

http://www.ncdhhs.gov/dma/radiology/DiagnosticUltrasound.pdf

Date added: October 2, 2011 - Views: 26

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Coding the Ob scan - The PLAZA Group, LLC - CMEs via Medical ...

Understand new CPT & ICD codes! Conflicts! • Member of AMA! • No financial conflicts! ... SMFM Statement on 76811! Because this new code will be assigned more RVUs than the basic obstetrical sonogram (76805), the SMFM believes that the new code

http://cmebyplaza.com/Registrants/GoHo12/Lectures/Copel%20Coding%20Update.pdf

Date added: May 12, 2013 - Views: 3

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Policy - Nevada

On January 1, 2008, Nevada Medicaid began requiring a National Drug Code (NDC) and an NDC quantity for ... CPT code 90650 is an FDA-approved HPV vaccine for females only age 9-26. ... 76811 Fetal and maternal eval w/detailed fetal anatomic exam 14 -26

http://www.medicaid.nv.gov/Downloads/provider/NV_BillingGuidelines_PT20-24-77.pdf

Date added: March 31, 2012 - Views: 6

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The American College of Radiology General Radiology ...

August 26, 2008 CPT codes added. Facility Form ... CPT Code 0028T deleted CMS PQRI Measures Form deleted. 3. GRID Data Dictionary October 12, 2010 ... 76811 76812 76813 76814 76815 76816 76817 76818 76819 76820 76821 76825 76826 76827 76828

http://www.acr.org/~/media/ACR/Documents/PDF/QualitySafety/NRDR/GRID/DataDictionaryGRID.pdf

Date added: November 2, 2012 - Views: 6

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Corporate Reimbursement Policy - Health Insurance for North ...

Modifier Guidelines This policy may apply to the following codes. Inclusion of a code in this section does not guarantee that it will be reimbursed.

http://www.bcbsnc.com/assets/services/public/pdfs/medicalpolicy/modifier_guidelines.pdf

Date added: December 29, 2011 - Views: 16

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Healthcare Operations Utilization Management Protocol

H. Current Procedural Terminology (CPT) Codes/ International Classification of Diseases (ICD-9) Diagnosis Codes ... Society for Maternal-Fetal Medicine (SMFM). White paper on ultrasound code 76811. Announcements. Washington, DC: SMFM; May 24, 2004. Available at:

http://www.healthplanofnevada.com/documents/provider%20files/Ultrasound%20Exam%20for%20Pregnancy_OBG020_092908R.pdf

Date added: February 2, 2012 - Views: 18

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maternal and fetal diagnostics - BCBSNC - Health Insurance ...

Page 3 of 9 An Independent Licensee of the Blue Cross and Blue Shield Association Maternal and Fetal Diagnostics Billing/Coding/Physician Documentation Information

http://www.bcbsnc.com/assets/services/public/pdfs/medicalpolicy/maternal_and_fetal_diagnostics.pdf

Date added: February 4, 2012 - Views: 7

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SPECIALTY CPT CODES DESCRIPTION - 1199SEIU Funds

SPECIALTY CPT CODES. DESCRIPTION: Primary Care Physicians: Internal Medicine ... 76811, 76812, 76813, 76814, 76815, 76816, 76817, 76818, 76819, 76820, 76821,76825, 76826, 76827, 76828, 76830, 76831, 76856, 76857, 76941 ... SPECIALTY CPT CODES DESCRIPTION. Otolaryngology. 70210, 70220, 70371 ...

http://1199seiubenefits.org/wp-content/uploads/2010/12/Radiology-Privileging-List.pdf

Date added: September 29, 2012 - Views: 28

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Radiology - Harvard Pilgrim Health Care

• Outpatient radiological services are reimbursed using the CPT code representing the ... 76776, 76801, 76802, 76805, 76811, 76817, 76830, 76831, 76856, 76857, 76870, 76872, 76881, 76975, 77058, 77059 ... • When both a CPT code and a HCPCs code exist that describe the same ...

https://www.harvardpilgrim.org/pls/portal/url/item/D0AD76450ED0423781AAC402D0F95F9C

Date added: November 8, 2011 - Views: 10

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By using Category II CPT Codes with Category I CPT/HCPC Codes ...

By using Category II CPT Codes with Category I CPT/HCPC Codes at the time a service is ... published annually in the CPT book as part of the general CPT code set. Codes released on ... 76801, 76805, 76811, 76813, 76815-76818, 80055 Diagnosis (C) ...

http://healthamerica.coventryhealthcare.com/web/groups/public/documents/webcontent/c051476.pdf

Date added: November 2, 2011 - Views: 18

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Medical Concurrent Review - Oklahoma Health Care Authority

The CPT code for this benefit is 76805. For additional gestations, 76810 will be paid when billed in conjunction with 76805. ... The CPT codes for this benefit include 76811, 76812, and 76816. Title: Medical Concurrent Review Author: BettisJ

http://www.okhca.org/WorkArea/linkit.aspx?LinkIdentifier=id&ItemID=8271

Date added: November 14, 2011 - Views: 6

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Claims Coding and Reimbursement Policy Update

CPT/HCPCS Codes Effective January 1, 2004, April 1, 2004 and July 1, 2004 ... instances of code combinations for which services will both be allowed, and it will not be necessary to bill with modifier -59: Code: Will be allowed with:

http://www.anthem.com/provider/nh/f5/s1/t0/pw_a032552.pdf

Date added: February 17, 2012 - Views: 24

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CareSource Provider Coding and Reimbursement Guidelines

Currently valid CPT/HCPC code or modifier usage CareSource seeks to apply fair and reasonable coding edits. We maintain a provider appeals function that will review, upon request, any claim that is denied based upon the use of a certain code, the

http://www.caresource.com/documents/oh-p-260_provider_coding_and_reimbursement_info-pdf

Date added: December 14, 2012 - Views: 2