Trying to find a resource

MFMcoder

Networker
Messages
37
Location
Wichita, KS
Best answers
0
I am trying to find a resource that explains when you do or when you don't bill a 76830 versus a 76817. I know the difference is one is non-ob and the other is ob. However, do you bill what the chief complaint is and that decides if its ob or not.? Or do you wait and see what the u/s reveals to know which way to code it? I thought there was a resource that explained which you use especially in confirmation of the pregnancy, when it is negative.
Thanks.
 

ahguzman

Networker
Messages
58
Location
Florence, SC
Best answers
0
76830 is non-obstetrical, 76817 is OB transvaginal. A transvaginal ultrasound may be performed separately or in addition to a transabdominal ultrasound. Report 76817 along with the appropriate abdominal scan. It is appropriate to code an obstetrical ultrasound for a patient who has an established diagnosis of pregnancy, who presents with indications necessitating the exam that may be pregnancy related, even when the outcome shows that the patient is no longer currently pregnant.
 

nielynco

Guru
Messages
106
Location
Guadalupita, NM
Best answers
0
I am trying to find a resource that explains when you do or when you don't bill a 76830 versus a 76817. I know the difference is one is non-ob and the other is ob. However, do you bill what the chief complaint is and that decides if its ob or not.? Or do you wait and see what the u/s reveals to know which way to code it? I thought there was a resource that explained which you use especially in confirmation of the pregnancy, when it is negative.
Thanks.
The CPT Assistant address this issue many years ago (October 2001) and the gist is that you use the code that represents the reason for the exam, not the result.

"Obstetrical Ultrasound Coding

To clarify, for female patients with an established diagnosis of pregnancy, determined by any method, and with indications for the ultrasound procedure that might be pregnancy related, it is appropriate to report an obstetrical ultrasound code from the 76805-76815 series.

For a patient with an established diagnosis of pregnancy (determined by any means), with signs and symptoms that could be pregnancy related and necessitating an ultrasound evaluation of the pelvis, the obstetrical ultrasound code(s) 76805-76815 should be reported, even if the outcome of the procedure is that the patient is now not pregnant or has an ultrasonic diagnosis that might be construed as being independent of the pregnancy (eg, acute appendicitis, torsed ovary, necrotic fibroid).

Pelvic Ultrasound Coding

If a female patient without an established diagnosis of pregnancy presents with gynecological problems necessitating ultrasound evaluation (eg, dysmenorrhea, oligomenorrhea, menstrual irregularity, pelvic pain, etc.), then it is appropriate to report a pelvic ultrasound code 76856 or 76857. The use of codes 76856 or 76857 is not predicated upon whether or not the outcome of the ultrasound procedure is the diagnosis of pregnancy or a complication related to a pregnancy."
 

MFMcoder

Networker
Messages
37
Location
Wichita, KS
Best answers
0
The CPT Assistant address this issue many years ago (October 2001) and the gist is that you use the code that represents the reason for the exam, not the result.

"Obstetrical Ultrasound Coding

To clarify, for female patients with an established diagnosis of pregnancy, determined by any method, and with indications for the ultrasound procedure that might be pregnancy related, it is appropriate to report an obstetrical ultrasound code from the 76805-76815 series.

For a patient with an established diagnosis of pregnancy (determined by any means), with signs and symptoms that could be pregnancy related and necessitating an ultrasound evaluation of the pelvis, the obstetrical ultrasound code(s) 76805-76815 should be reported, even if the outcome of the procedure is that the patient is now not pregnant or has an ultrasonic diagnosis that might be construed as being independent of the pregnancy (eg, acute appendicitis, torsed ovary, necrotic fibroid).

Pelvic Ultrasound Coding

If a female patient without an established diagnosis of pregnancy presents with gynecological problems necessitating ultrasound evaluation (eg, dysmenorrhea, oligomenorrhea, menstrual irregularity, pelvic pain, etc.), then it is appropriate to report a pelvic ultrasound code 76856 or 76857. The use of codes 76856 or 76857 is not predicated upon whether or not the outcome of the ultrasound procedure is the diagnosis of pregnancy or a complication related to a pregnancy."
Thank you Melanie.
 
Top