Wiki fetal biophysical profile

[mlange85]

Hello!
I have some questions regarding billing for a fetal biophysical profile (cpt code 76819) I have been getting paid for these, except my medical mutual. We are doing biophysical profiles on a few patients because they have gestational diabetes. So we have been using the pregnancy code along with a dx code of gestational diabetes in 3rd trimester. and CPT code 76819. Any ideas? Advise?
Thank you!
Mary L

 

[talton0206]

You may need to check the payer coverage policy, some may only provide coverage insulin or medication controlled GDM. If you are using the "unspecified control" code, you may need to submit corrected claims with the more specific code.