As the patient is referred to your MFM practice to confirm/refute the anomaly visualized on outside ultrasound, we recommend utilizing the O35.- series as the indication for performing the anatomy evaluation. This clinical scenario would also support performance of a 76811. The SMFM listing of recommended indication codes for performance of a 76811 can be found at this link: https://onlinelibrary.wiley.com/doi/epdf/10.7863/ultra.16.01036.
This service is reported with CPT code 59070 Transabdominal amnioinfusion, including ultrasound guidance.
The ICD-10-CM alphabetic index indicates that the appropriate code for anhydrdamnios is O41.8X-- Other specified disorders of amniotic fluid and membranes, ________ trimester. The sixth character reflects the trimester and the 7th character reflects the fetus affected.
Z36.4 is an appropriate diagnosis for this circumstance. If a patient has confirmed IUGR in the current encounter, you would report a diagnosis from the O36.5- category. If you have clinical concerns about IUGR, but it is not confirmed by the ultrasound, you would report Z03.74 Encounter for suspected problem with fetal growth ruled out. There are no other clear scenarios in which the use of Z36.4 is appropriate. Please note that some insurers may require you to use an O36.5- category code as a payable diagnosis in this situation, even if there is no IUGR, as the condition is "suspected."As always, myself or Fadi (past Chair of the Committee), or any of our committee members are available to answer any questions. You can utilize this forum if you feel comfortable, or you can email any of us privately through communities, the SMFM website, Facebook, or personal emails (email@example.com). I'll try to post Q&A's on here that come up frequently so that we can get the information out to more members.Thanks