Is 76815 or 76816 Appropriate for a 36-Week Growth Scan?
Question: A patient pregnant at 36 weeks came into our ob-gyn practice for a growth scan of the fetus. Should we report 76815 or 76816 for the encounter? Nebraska Subscriber Answer: In this case, 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) is the correct code to assign. Code 76816 is used when the provider is reevaluating fetal size, interval growth, or abnormalities they found on a prior ultrasound. On the other hand, 76815 (Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses) is limited to a focused “quick look” assessment of one or more of the key elements, which include the following: Mike Shaughnessy, BA, CPC, Production Editor, AAPC
