Question Help with NT study 76801

MFMcoder

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Hello - I am needing help with an audit that says I should bill a 76815 instead of a 76801 with a 76813 for an NT study. Is there any resources out there that can help me?
 

dbolivar1

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Albuquerque, NM
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Hello - I am needing help with an audit that says I should bill a 76815 instead of a 76801 with a 76813 for an NT study. Is there any resources out there that can help me?
Do you mean NST? If so it would be 59025. I work in the OB triage and following listed are the most CPT codes we use for US.

US ABD for pregnancy:
76801 less than 14 wks.
76805 more than 14 wks.
76815 bedside or limited
76817 Transvaginal US
 

Cmama12

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It would depend what's documented in the report. Is it just for the NT? We normally see 76801/76813.
If the ultrasound meets all the components for 76801, then bill that. If not then 76815.
 

nielynco

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Guadalupita, NM
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Hello - I am needing help with an audit that says I should bill a 76815 instead of a 76801 with a 76813 for an NT study. Is there any resources out there that can help me?
In order to bill both 76801 and 76813 you need to have both separately documented. If the only purpose of the exam was for the nuchal translucency then you only bill 76813 and this code is used whether the ultrasound is done vaginally or abdominally. 76815 is for a single quick measurement and would not be appropriate for a complete abdominal ultrasound (and documented as such) with NT study. You need to look at the documentation and then appeal the finding if you have met the requirements for both codes.
 
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