I should mention, when I replied earlier I meant the order of my preference for billing. But I don't think that was very clear.
Fadi and I were discussing this just now and were saying that 76813-52 will likely get denied if you then bring them back for the 76813 in 2-3 days (which I forgot to mention).
To be clear, consider the order of choices to bill as follows:
76817 (if you did a TV and got all the components, do NOT bill the 76813 that day)
76801 (if there is a separate indication to perform this study that day, do NOT bill the 76813 that day)
76815 (just bill the limited - FHR, placenta, do NOT bill the 76813 that day)
76813-52 (last resort, high likelihood for denial, not our favorite choice)
Then you would have the patient return if able to within the GA/CRL window and bill the 76813 when you bring them back in 2-3 days.
Check with your payer or f/u on your denials to see next steps
phew! hopefully that's better - goes to show I should stop responding to these emails so early prior to coffee - ha ha!
have a great day
v
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Vanita Jain, MD
Chair, SMFM Coding Committee
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Original Message:
Sent: 07-14-2020 05:01
From: Vanita Jain
Subject: Nuchal Translucency
A few options (depending on TA/TV approach)
•76817 if you attempted TV and document all required components
•76815 (Limited Ultrasound Study)
•76813-52 (Reduced Service)
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Vanita Jain, MD
Chair, SMFM Coding Committee
Original Message:
Sent: 07-13-2020 16:42
From: Monica Dowdell
Subject: Nuchal Translucency
Good afternoon
When an NT is attempted but could not be visualized. What is the correct way to bill? A 52 modifier or not billing at all
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Monica Dowdell
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