Ob-Gyn Coding Alert
Second Scan in Trimester? Read This First
Question: Patient had a dating U/S two weeks ago and a 76801 <14 wks was charged at that time. She returned today for an OB visit, and our Dr. could not hear heart tones with Doppler. She is now 11weeks 6 days. Is it proper to charge 76815 today for just doing a quick scan? This is her second scan in the first trimester.
Colorado Subscriber
Answer: Yes, you can bill for the ultrasound, but payment will be another matter. Make sure that your diagnosis coding reflects that this ultrasound in medically indicated.
Assuming the 76815 (Ultrasound, pregnant uterus, real time with image documentation, limited [e.g., fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume], 1 or more fetuses) picked up a heartbeat, your diagnosis would be V23.87 (Pregnancy with inconclusive fetal viability) as this reflects the need to do it, even though the result was normal.
ICD-10: When your diagnosis system changes next year, V23.87 will expand into the O36.80X- (Pregnancy with inconclusive fetal viability) category, with the seventh digit dependent on the fetal number (i.e., first fetus, second fetus, etc).
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