Coding

  • 1.  Detailed first trimester ultrasound

    Posted 05-06-2022 19:04
    I am curious about those doing the detailed first trimester ultrasound (unassigned CPT).  Are most doing the combined 76801 AND 76813? Or 76999?

    Any insight on the timeline for a CPT for detailed first trimester ultrasound?

    Thanks!

    https://www.smfm.org/coding/white-papers/221-billing-scenarios-for-imaging-and-aneuploidy-screening-in-the-first-trimester-replaces-oct-2017-white-paper





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    Kimberly Ma
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  • 2.  RE: Detailed first trimester ultrasound

    Posted 05-08-2022 09:17
    Hello
    Yes, we have 2 white papers on this topic to help with coding under coding resources, white papers
    They were published last year 6/2021 and 10/2021
    we are suggesting the 76801 + 76813 - as a stop gap. 
    There is also a cheat sheet/table that was published in JUM that gives you the ICD-10 codes (that's under coding resources too) for performance of this study

    As to your other question regarding time line.... We have been working with ACOG since 2017 to get a new code. 
    Its a long process that also requires collaboration with other societies that perform/educate in the arena of first trimester imaging such as the SRU, ACR, AIUM and PQF, and also involves some potential risk of impacting other imaging codes - particularly codes that deal with fetal anatomy - (76805, 76811, 76816).   So it is not as easy as 'apply for a new code', it is likely that RVUs for all fetal anatomy codes will be reevaluated and reassigned.  This could be a good thing.... or have grave potential for reduced reimbursement.   We are trying to balance those risks and collaborate with all the societies involved. 

    Best,
    Vanita

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    Vanita Jain, MD
    Chair, SMFM Coding Committee
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