Advanced Search

Primary Care Coding Alert

READER QUESTIONS :

Be Aware of Surroundings on US Claims

Published on Thu May 21, 2009

Question: The FP meets a 27-year-old patient who is 16 weeks pregnant at the local hospital after an accident at her workplace. She fell down the stairs and reports pain in her twisted left ankle. The FP performs a level-three E/M in the hospital outpatient unit, during which she diagnoses and wraps a sprained left internal collateral ligament; then, she performs obstetrical ultrasound (US). After examining the US, the physician determines that the fetus has not sustained any injury. Do I need a modifier for the US? Georgia Subscriber Answer: Since you are using the facilitys equipment, youll need a modifier for the US. On the claim, report the following: " 76805 (Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester [> or = 14 weeks 0 days], transabdominal approach; single or first gestation) for the US " modifier 26 (Professional component) appended to [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Primary Care Coding Alert

View All