Wiki ICD 10 code for medical necessity for a 20 week sono / ultrasound

[TonyaMoore5]

I am trying to find out what other coders are using for a ICD 10 code for a 20 week ultrasound. I need a medical necessity code for it to be covered and sometimes they just do it to check the anatomy at 20 weeks. Please help. I cannot find the answer anywhere.

~Tonya

 

[Cmama12]

We routinely use Z36.3 - there is really nothing else unless the mother has other dx, and even so, the reason for doing it remains an anatomy check so Z36.3 is primary.

 

[SharonCollachi]

I am trying to find out what other coders are using for a ICD 10 code for a 20 week ultrasound. I need a medical necessity code for it to be covered and sometimes they just do it to check the anatomy at 20 weeks. Please help. I cannot find the answer anywhere.

~Tonya

That's not a medical necessity. You should be asking the doctor what the medical necessity was, and if the answer is, "that's what I always do", "I want to know", "because I'm the doctor", then the answer is, for future patients, "We will perform a 20-week ultrasound, however, your insurance may not cover it unless you are having symptoms that necessitate the ultrasound. If it is not covered, your cost will be $_____, which is due and payable 15 days after your insurance company denies your claim. You always have the right to decline the procedure". And have the patient sign for financial responsibility.