It’s a familiar image, shared with friends and family, or even posted on Facebook by many expectant mothers as an announcement – “I’m pregnant!” – or as a way to introduce the very first images of her infant-to-be. The ultrasound is an important mile marker of pregnancy, and it’s also a crucial diagnostic tool for the ob-gyn practice. Ultrasound is considered a very safe procedure for both the normal gynecology patient and the obstetric patients – mother and fetus. Ultrasound does not produce ionizing radiation or pose a radiation risk.
As a medical coding professional in the ob-gyn setting, it’s an absolute must that you understand the details of how to code for a range of procedures and diagnoses related to ultrasound.
Ultrasound Basics for Coders
Ob-gyn practices perform ultrasound billing services procedures to interpret:
The CPT obstetrical codes lie within the code series 76801-76828 and include:
- Traditional ultrasound
- Fetal biophysical profile(s)
- Doppler velocimetry of the fetal umbilical and middle cerebral artery
- Echocardiography of the fetus
Coding Details for Ultrasound Services
According to the CPT guidelines, all diagnostic ultrasounds require a permanently recorded image, and a final written report. Coders too must understand if they are billing and coding ultrasound scans as a global and complete scan, a recorded image, or as interpretation/documentation of the ultrasound scan only (with the 26 modifier).
A few other considerations include:
- The CPT code definitions must be reviewed carefully
- Check if the add-on code “+” symbol is denoted at the beginning of the CPT code
- Don’t use a 51 modifier with the “+” symbol code
- Add the modifier 59 for each additional fetus when reporting multiple gestations:
- 76816 for baby A
- 76816-59 for baby B
- Review to determine the approach of how the ultrasound was performed
Learn to Code and Bill for Ultrasound From an Expert
Join coding and auditing specialist Lori-Lynne A. Webb as she provides in-depth strategies and explores the most up-to-date concepts for ultrasound billing services in the ob-gyn physician’s office. You will learn to put in place correct clinical documentation, and coding and billing for both obstetric and gynecologic ultrasounds. Lori-Lynne will help you become more competent in billing for ultrasounds and ensuring your practice receives all the payments it’s properly due.
