Wiki OB coders..Please help!

[mhissy18]

Hello! I am a new OB coder and work in a private facility. I am having doubts as to how CPT code 76805, 76816, and 76811 are used. I understand that 76811 is mostly done for/with high-risk patients unlike 76805. Now, my concern is, I was told that a follow-up visit from 76811 is 76805. Then, 76816 is billed if the patient comes back for another follow-up. Is this correct?

Thank you,
Grace K, CPC

 

[lbrookin]

Hi Grace,

Take a look at this link: http://static.aapc.com/a3c7c3fe-6fa...ee89/2f64d6c1-d307-46b9-b8b7-4cf75bf534e2.pdf
This presentation seems to cover everything you ever wanted to know about OB u/s!! In it, I believe, is the answer to your questions.

It doesn't look like 76805 is a f/u code at all but rather the code for a basic u/s of a 2nd trimester or higher pregnancy. It seems that the 76816 is used as the f/u to 76811.

Read over the aapc presentation and you'll probably get the answer, and more!

Here's another one to look at too:

https://www.aapc.com/blog/30124-gather-components-for-ob-ultrasound-codes-76805-and-76811/

Hope this helps!

 

[mhissy18]

Hi Grace,

Take a look at this link: http://static.aapc.com/a3c7c3fe-6fa...ee89/2f64d6c1-d307-46b9-b8b7-4cf75bf534e2.pdf
This presentation seems to cover everything you ever wanted to know about OB u/s!! In it, I believe, is the answer to your questions.

It doesn't look like 76805 is a f/u code at all but rather the code for a basic u/s of a 2nd trimester or higher pregnancy. It seems that the 76816 is used as the f/u to 76811.

Read over the aapc presentation and you'll probably get the answer, and more!

Here's another one to look at too:

https://www.aapc.com/blog/30124-gather-components-for-ob-ultrasound-codes-76805-and-76811/

Hope this helps!

Thank you for your response and I appreciate the links