Coding

  • 1.  12 week first time scan

    Posted 20 days ago

    Hi! If a patient without any prior ultrasounds comes at 12 weeks requiring then dating and an nt, do you bill only 76813 or also bill a 76801 w it (both codes)?  Thanks



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    Diana Garretto
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  • 2.  RE: 12 week first time scan

    Posted 19 days ago

    Hi Diana,

    It seems from your question that you should bill 76813 since your are performing the ultrasound portion of the NT screen. This includes the CRL measurement so includes dating as well. If you have another indication (besides just dating) to look at the gestation sac/embryo and maternal anatomy, then 76801 may be billed as well. The SMFM coding committee has a white paper on this topic.

    https://www.smfm.org/coding/white-papers/41-smfms-white-paper-on-billing-combination-of-76801-and-76813-revised-11-20-10

    https://www.smfm.org/coding/white-papers/112-smfm-coding-committee-white-paper-billing-of-76801-and-or-76813-with-cfdna-screening

    Fadi



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    Fadi Bsat, MD, FAIUM
    Chair, SMFM Practice Management Committee
    Past Chair, SMFM Coding Committee
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    Original Message