I am not expert in coding. but to come out with some clues I post this, breaking the silence!
I dont understand the real meaning of 'Fetus failed BPP'. It is performed by the physician and BPP is reported by the physician. BPP done ,done and reported it as 10/10, 8/10, 6/10 or low, whatever. If the doctor is not satisfied with that score, she waits, repeats or goes for active management.
You have definite CPT Codes for BPP 76819, and follow up or repeat study, can go for 76828..
ICD-9 code, please check whether V code V67.59, V67.6 or V67.9 could fit in.More appropriately one from V28.3 encounter for routine fetal US NOS. It is Physicians discretion to say how many routine US BPP screening needed for a fetus at that time of pregnancy with the need for BPP. BPP can be repeated as many times as the condition warrants .
My view is that there needn't be a routine status for BPP. BPP is done with the purpose fetal surveillence any number of times especially nearing term/labor the frequency can be often daily or twice a day. Then how can be label a stipulated routine. every encounter for BPP is a routine! as the condition needs.
If not V.28.89.
Check withV58.9 after care code.
Please find out if there is code for abnormal or undiagnosed ultrasound findings.
If not satisfied with any, undiagnosed 799.89 or 799.9.
Yet another suggestion is ask/verify with your doctor about which part of the BPP is failing so that you can code from that failure of system(s)- say for eg, if breathing movement score , FHR, amniotic fluid score/level, fetal movements score, or fetal tone scor ewhich one is failing and you can code it or in combination of all those score-respiratory,cardiac, amn fluid or the movements.
Let me give you the components of BPP:
Amniotic fluid level score, fetal movement, FHR, respiratory movements (Breathing movements) and the Fetal (Muscle) tone; each one has two points to add up to the BPP to a total of 10.
She or he would be definitely not happy with any or more of these scores to say the BPP to be repeated or take immediate management measures.
By the way, my big question is :should we code for the result fo the BPP at all? or do away with just BPP done or repeated or follow up study enough to code ?
we have our experts who would kindly help us in these aspects of coding, I hope and I am sure.
Hope I gave some clues. Please try to work it out!!