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First OB visit - how to bill the ultrasound

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kellyl710

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When a patient comes in for her first visit to establish her pregnancy, we bill an ultrasound. There has been debates in our office about whether the ultrasound should be billed as a GYN or an OB ultrasound. What do any of you bill? 76817 - pregnant ultrasound or 76856 - non obstetric ultrasound. Thanks!
 
If the patient's pregnancy has been already determined you would use the 76817 Pregnancy ultrasound. (if patient had positive pregnancy test). If pregnancy is unknown you would use the 76856.
 
Ok, so if she comes in and the urine pregnancy test says positive before the dr sees her then we bill the OB ultrasound? That's the problem we're having; some are saying we would bill a GYN ultrasound at that visit. But her first visit she's coming in because of a missed period and we do an ultrasound because her urine pregnancy test in the office comes up positive.
 
I am under the assumption that you code according to what you know at the end of the exam, so if the patient has a viable pregnancy, you use a OB ultrasound code. If the patient was found to be missed ab or not confirmed pregnant, you use a GYN ultrasound code.
 
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