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Thread: Pregnancy Coding

  1. #1

    Red face Pregnancy Coding

    AAPC: Back to School
    I work for a Radiology Practice in Connecticut. I have an US PREGNANCY DIAG-TRANSABDOMINAL AND US PREGNANCY TRANSVAGINAL ORDERED by the OB-GYN. The patient had a positive pregnancy test but is experiencing vaginal bleeding. Once the exam was performed it was determined that the patient had no intrauterine pregnancy. A serial beta-hcg level was recommended. The radiologist coded the exams as 76856 and 76830-59. Some coders I have spoken to see this as a Pregnancy Diagnostic exam -76815 while others feel the Radiologist has coded it correctly. My feelings are that since the OBGYN believed the patient was pregnant and ordered a pregnancy US, it should be coded as a pregnancy diagnostic. The determination of whether there was a viable fetus was only made after the exam was performed. Any thoughts????

  2. #2


    CPT states, through its companion publication, the CPT Assistant,5 that the use of OB ultrasound codes are appropriate anytime the patient has been established to be pregnant, by any method or means, and the indications for the ultrasound study might be or could be pregnancy-related, regardless of whether the outcome might not confirm a pregnancy, or might produce a diagnosis that is not pregnancy-related. For the patient who has not been diagnosed as pregnant, and the indications for the ultrasound study
    are not pregnancy-related, the use of non-OB ultrasound codes is appropriate, regardless of whether the outcome of the study shows a pregnancy or complication related to pregnancy.
    hope this helps

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