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Amnisure-Does anyone

  1. Question Amnisure-Does anyone
    Medical Coding Books
    Does anyone bill for amnisure? What is the CPT code or is it considered part of the OB global charge?

  2. Default
    The procedure is inclusive to antepartum care

    Here is a paste from May 2009 AAPC forum question that references to an ACOG response

    I inquired with ACOG about the Amnisure as well, here is the response I received: "There is no specific CPT-4 code for the amniotic fluid swab test (Amnisure). The swab test is considered a minimal procedure and would be included as part of the pelvic exam."

    Here is a link for Aetna just to give a payer specific view on this.

    Aetna considers the AmniSureTM ROM (rupture of membranes) test experimental and investigational for detecting preterm ROM and all other indications because of insufficient evidence of its clinical effectiveness over standard diagnostic methods for detecting ROM.

    Aetna then specifically states what CPT and ICD they WILL NOT cover: (in other words "don't bother billing us for these")

    CPT Codes / HCPCS Codes / ICD-9 Codes
    HCPCS codes not covered for indications listed in the CPB:
    S3628 Placental alpha microglobulin-1 rapid immunoassay for detection of rupture of fetal membranes

    ICD-9 codes not covered for indications listed in the CPB (not all-inclusive):
    630 - 677 Complications of pregnancy, childbirth, and the puerperium
    V22.0 - V23.9 Supervision of pregnancy
    V28.8 Other specified antenatal screening

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