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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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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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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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Changes to Reimbursement Policies - UHCCommunityP...

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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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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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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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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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: 33

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CPT Codes: Ultrasounds - Howard Radiology

OB Detailed Anatomy Survey (18-20 wks).. 76811 OB Follow up..... 76816 OB Limited..... 76815 OB Re-eval (Fetal Size, Growth)..... 76816 ... CPT Codes: Ultrasounds T I 443.574.5800 F I 443.574.5822. Title: Layout 1 Author: Baker Created Date:

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

Date added: September 26, 2012 - Views: 64

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Coding Edge Tests Your Knowledge - AAPC

online at www.aapc.com/testyourself/. Once you go there and take the test, ... When ®appending multiple modifiers to a CPT code, which is the correct sequencing? a. ... b. 99214, 76811, 76827 c. 99243, 76811, 76820 d. None of the above 6.

http://static.aapc.com/5548A1AF-4C9F-49A2-BFE0-BFA7D2344700/c699c38a-b32f-4b68-adb4-b340b0e1b167/5fca2a13-73ab-4bf9-9cdb-1fc07318a830.pdf

Date added: October 28, 2012 - Views: 8

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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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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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OBSTETRICAL ULTRASOUND IMAGING GUIDELINES

¾ CPT code 76811 is limited to one procedure per pregnancy. o Ultrasound Codes: ¾ Only one of the following ultrasound procedure codes is reimbursed on the ... 2004.http://www.askleslie.net/rads/White_Paper_on_Ultrasound_Code_76811.pdf. Accessed September 22, 2009

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

Date added: October 31, 2011 - Views: 94

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

# ˘ˇ ˆ ˇ˘ ˇ CPT 83655 ˛ˇ ˘ˇ ˙˝˝ˆ 5 ˙ ... 76801, 76805, 76811, 76813, 76815-76818, 80055 136 V22-V23, V28, 640.x3, 641.x3, 642.x3, ... Payable diagnosis codes and procedure codes for various claim type

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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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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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: 40

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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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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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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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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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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 ...

Centers for Medicare & Medicaid Services (CMS) has revised the Healthcare Common Procedure Coding System ... 76811 76812 76813. Commonwealth of Massachusetts MassHealth ... Medical Association’s latestCurrent Procedural Terminology (CPT) code book and to the HCPCS Level II

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

Date added: September 26, 2012 - Views: 5

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

Understand new CPT & ICD codes! Conflicts! • Member of AMA! ... • 76811 Ultrasound, pregnant uterus, real time with image documentation, ... – Code includes ultrasound guidance so DO NOT bill that separately!!

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

Date added: May 12, 2013 - Views: 3

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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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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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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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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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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, ... ****Medicaid requires a diagnosis code specifying fetal anemia risk, such as isoimmunization (656.13) or parvovirus infection (079.18)****

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

Date added: October 7, 2012 - Views: 2

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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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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

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OB/GYN Billing Guide - NC DHHS

76811 • The CPT code should be billed as one detail line with one unit of service. ... When billing for IUD insertion, CPT code 58300 is used. The CPT code for removal of IUD is 58301, which includes an office visit. Depo-Provera

http://www.ncdhhs.gov/dma/bulletin/OBGYNSpecBull.pdf

Date added: October 30, 2011 - Views: 160

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PRIOR AUThORIZATION FAx FORM - Louisiana Health Connect

CPT Code aaaaa CPT Code aaaaa CPT Code aaaaa Description: Created Date: 12/15/2011 9:37:27 AM ...

http://www.louisianahealthconnect.com/files/2012/01/LA_Prior_Auth_Fax_form_12_2011.pdf

Date added: November 12, 2012 - Views: 5

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

5. Episiotomy (CPT code 59300) 6. All postpartum care through 6 weeks, including suture removal, Pap smears and discussions ... Professional component of ultrasounds when deemed medically necessary (CPT codes 76801, 76802, 76805, 76810, 76811, 76812, 76815, 76816 76817, 76825, 76826, 76827,

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

Date added: February 12, 2014 - Views: 1

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CCI Edits - coderscentral.com

Cataract CPT® Coding Tips A number of services are bundled into code 66982 and 66984 including those for canthotomies, iridectomies, iridotomies, capsulotomies, the use of some pharmacologic agents, etc. Some

http://www.coderscentral.com/images/HandyCoder/HandyCoderSampleOphth.pdf

Date added: October 16, 2011 - Views: 47

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Healthcare Operations Utilization Management Protocol

H. Current Procedural Terminology (CPT) Codes/ International Classification of Diseases (ICD-9) Diagnosis Codes Routine fetal ultrasounds CPT codes covered if selection criteria are met: ... code 76811. Announcements. Washington, DC: SMFM; May 24 2004.

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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Obstetrics/Gynecology Payment Policy - FCHP - Massachusetts ...

Obstetrics/Gynecology Services Payment Policy Page 4 of 5 effective 05/01/2014 • 4 to 6 antepartum care visits only have been performed, bill CPT code 59425 –

http://www.fchp.org/providers/medical-management/~/media/Files/ProviderPDFs/PaymentPolicies/ObstetricsGynecologyPaymentPolicy_052014.ashx

Date added: March 27, 2014 - Views: 1

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CONFIDENT CODING FOR OB/GYN

How to code for multiple ultrasounds and other tests What’s new for 2009? New ICD-9 CM codes in OB and Gyn! ... 4-6 antepartumvisits are billed using CPT code 59425 7+ antepartumvisits are billed using CPT code 59426 Delivery only or delivery with postpartum care only:

http://djk9qtinkh46n.cloudfront.net/e7fe2e86-ee05-475b-ac2c-bdc28fea95c1/be5d6399-19fe-487b-8494-758a2e626c0d/15deaa13-f2c0-4887-9831-7e4e034eb21d.pdf

Date added: February 22, 2012 - Views: 54

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

Ultrasound performed during pregnancy is a diagnostic test used to visualize the uterus and fetus. ... 76805, 76810, 76811, 76812, 76815, 76816, 76817, 76818, 76819 ... CPT codes 84703 and S3626 removed from Section IV Billing/Coding section. CPT code 84703 is for qualitative hCG (is it ...

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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Policy - Nevada

Updated: 08/01/2014 Provider Type 20, 24 and 77 Billing Guide ... 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 weeks

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

Date added: March 31, 2012 - Views: 6

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Ultrasound Procedure Procedure Code(s) Payment

Ultrasound Procedure Procedure Code(s) Payment Abdomen soft tissue 76705 98.71 ... Pregnant Uterus with detailed fetal anatomic examination 76811 177.24 Renal Artery Complete *76770 93975 337.05 Testicle/Scrotum complete *76870 93975 331.96

http://www.mooresoundimaging.com/wp-content/uploads/2012/04/Reimbursement-2012.pdf

Date added: March 27, 2013 - Views: 9

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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 provided, you could save time, improve efficiency, and increase patient satisfaction.

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

Date added: November 2, 2011 - Views: 18

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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