Hello, i always get thrown on this type of scenario. The patient has postpartum bleeding, and the CPT codes came in as non- ob codes-76856 and 76830. Should they be OB codes 76815 and 76817? Both transabdominal and transvaginal were done, per documentation. I will use O72.1 for the diagnosis code.
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Wiki Non OB CPT codes vs OB CPT codes
- Thread starter brieck41
- Start date
nielynco
True Blue
The CPT Assistant October 2001 has addressed this issue in the past. The question posed was about doing an ultrasound in the ER department, but the article indicates that this coding is also to be used by the physician and outpatient settings.
Diagnostic Abdominal/Pelvic Ultrasound
The choice of the appropriate ultrasound (US) code is not always readily evident when related to ultrasound involving females of child-bearing age. This is especially true based on the descriptor language reference to a "pregnant uterus." The question posed is whether this reference is intended to indicate a known condition: a) prior to performing the diagnostic ultrasound; or b) the finding derived from the diagnostic ultrasound.
The following scenarios involve female patients of child-bearing age who present to the emergency department (ED) with abdominal pain and perhaps some vaginal bleeding for whom a nonvaginal ultrasound is performed. The relevant ultrasound codes are 76700-76705, 76805-76816, and 76856-76857. As you will see from the following clinical examples, the question is, which diagnostic ultrasound code should be reported?
Clinical Examples:
Coding Example #1: The patient is not known to be pregnant prior to ED admission. Prior to US, pregnancy testing is performed in the ED with positive findings. The US demonstrates an intrauterine pregnancy.
Coding Example #2: The patient is not known to be pregnant prior to ED admission. Prior to US, pregnancy testing is performed in the ED with positive findings. US demonstrates an ectopic pregnancy.
Coding Example #3: The patient is not known to be pregnant prior to ED admission. Prior to US, pregnancy testing is performed in the ED with positive findings. US does not demonstrate a pregnancy.
Coding Example #4: The patient is not known to be pregnant prior to ED admission, pregnancy testing is not performed, and US demonstrates an intrauterine pregnancy.
Coding Example #5: The patient is not known to be pregnant prior to ED admission, pregnancy testing is not performed, and US demonstrates an ectopic pregnancy.
Coding Example #6: The patient is not known to be pregnant prior to ED admission, pregnancy test is not performed, and US does not demonstrate a pregnancy.
Coding Example #7: The patient is definitively known to have an intrauterine pregnancy based on previous diagnostic and/or physician evaluation, and US now demonstrates an intrauterine pregnancy.
In your case, the uterus is being evaluated for possible retained products of conception so it is directly related to obstetric purposes and the gyn ultrasound codes should not be reported.