Get The Reimbursement You Deserve When You Code For Ultrasound - For Ob-gyn

By Author: Nancy Rose
Total Articles: 53
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When you provide more than one ultrasound per obstetric patient - even during the same visit - make sure you code for them. Otherwise, you could strike down your practice's bottom line.


Apart from 76801 and 76805, you generally will use the other pregnancy-related code for ultrasound (76810-76828) for high-risk or problem pregnancies. If a patient presents with problems that indicate she may be high-risk or if a routine ultrasound indicates a problem that may need to be followed, the ob-gyn may decide to schedule more than one ultrasound during the pregnancy, perform one or more amniocenteses, or even do multiple ultrasonic procedures during the same visit.



Even though the ultrasonic guidance is a different procedure from the regular ultrasound, you should append modifier -51 (Multiple procedures) to 76946 because it is a similar procedure and many carriers consider it a multiple. If the doctor performs the regular ultrasound on a different day than the amniocentesis with ultrasonic guidance, then you would not need to use modifier -51 when you code for ultrasound ...
... /i> because the two procedures are of different types.



Remember, however, that if you're reporting ultrasonic guidance, the ob-gyn should include a report in the medical record documenting the procedure, which includes supervision and interpretation. If the physician also performs a regular ultrasound on the same date of service, that requires its own separate report.



When you code for ultrasound, you must have the correct documentation in place, there is a good chance you'll get paid on appeal. But the easiest way to win an appeal is to prove that both the guidance and the regular ultrasound were performed, so documentation for both can be vital. Proper documentation gives the insurance companies a clearer picture of what is going on with the patient and it helps in getting the reimbursement you deserve.


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