Wiki Z3A.XX Gestational Week Codes

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vsmith154

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Charlottesville, VA
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Hi,
We are receiving Clearinghouse rejections for our 76815 and 76817 stating that we need to use the gestational week codes.

We code an office visit and ultrasound with Z32.01. Do we continue to use the Z32.01 with the ultrasound, or do we just use the Z3A.xx code?

For example:
99205-25 with Z32.01
76815 with Z3A.XX

Thank you!
 
0
Hi vsmith154,
What was the intent; "reason for the ultrasound being performed"? There has to be an order from the provider on why this ultrasound was ordered. There are so many reasons why an ultrasound is performed. Examples: spotting, fluid leakage, validate dates of gestation, so forth... are the common scenarios I witnessed.
You would not want to simply assign Z3A.xx for a diagnosis code either "solo" or as a "primary" diagnosis code - you will probably be denied. The Z3A.xx is supposed to be the the subsequent diagnosis code except those identified in the ICD book (O00-O08 or Z33.2).
Please reach out if you have any additional questions,
Dana Chock, CPC, CANPC, CHONC, CPMA, CPB, RHIT
 
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This situation does seem a little odd, based on my experience. Typically sonos are not done at initial confirmation of pregnancy visits. They are done further along during the antepartum care.
If you are starting the maternity care and flowsheet, the visit is part of global maternity. If you are not, and this is only a confirmation of pregnancy, then sono not usually done. At least not from my experience.
And as previously advised by @danachock, there must be an order for the sonogram which should point you to the diagnosis for this specific case.
 
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I do have something to offer on this for vsmith154
We all started our coding training certification somewhere.
You know and I both know there was never a benign case "no abnormality discussed" and how to code it. I personally never saw this in all those those practice exams or even actual exams from any facility. If you are ever provided a case that has no abnormality noted. You provide the reason why the testing was performed.
 
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I am so sorry, I posted this question and never answered y'all.
We are an abortion care provider. We must perform an ultrasound for gestational dating.
I realize now, that coding the ultrasound with the Z32.01 and the Z3A.XX is the way it should be coded. :)
 
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