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NST's what documentation is required in order to bill

  1. #1
    Default NST's what documentation is required in order to bill
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    Hello - I am looking for details invoving NST's. In our OB clinic setting the nurses perform NST's and the provider will read it and document the patients chart "NST Reactive" , which then I release the charge.

    I have been asked the following question by our Birthplace Dept.

    We're developing a process / policy for when we complete them in the OB Outpatient world. Currently docs are not billing for them when they are done in our outpatient labor/delivery

    Thanks !!

    Sheri Stevens
    OB Coding
    S. Stevens, CPC

  2. Default Nst
    I would be interested in this same info. I looked in ACOG books & can't find a template of required info for billing. Also, anyone know if there is a limit of how many most insurance companies will pay for? What about NST's done at the time of OB triage (for example - false labor undelivered) can doc bill for 59025-26 for NST performed at the time of triage? is there a time line of how soon after triage the doc needs to document strip? thanks!

  3. #3
    Daytona Beach, FL
    Default Still looking for the answers!
    Does anyone have the answer to these questions? I am auditing OB charts and need to know what kind of documentation will justify billing the NST.

    Jodi Dibble, CPC

  4. #4
    Bay City, Michigan
    Default NST documentation
    I found this in the Medicare's Claims Manual 100.1.2

    6. Interpretation of Diagnostic Radiology and Other Diagnostic Tests
    Medicare pays for the interpretation of diagnostic radiology and other diagnostic tests if the interpretation is performed by or reviewed with a teaching physician. If the teaching physician's signature is the only signature on the interpretation, Medicare assumes that he/she is indicating that he/she personally performed the interpretation. If a resident prepares and signs the interpretation, the teaching physician must indicate that he/she has personally reviewed the image and the resident's interpretation and either agrees with it or edits the findings. Medicare does not pay for an interpretation if the teaching physician only countersigns the resident's interpretation.

    I know that this is for a teaching physician, but I would think that it would apply without a resident and that the physician must documement they reviewed the image and their interpretation/findings.

    Hope this helps.
    Lynn Wilks

  5. #5
    I bill for NST's outside the hospital frequently and have no problems getting them paid. The provider needs to document the fetal tracing Category 1 or Cat. 2, fetal heart rate, and any additional comments. There is an NST Form that can be completed as well. When the NST is performed in the hospital and monitoring is done by the nurses but the provider does the interpretation, bill the same code, 59025 with modifier "26" for the professional componant. This also applies to remote monitoring of the fetal strip according to ACOG.

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