Thank you all for your input. The CPT descriptions and the respective elements of any study should be carefully considered in answering this question. While billing for a BPP + limited study may not be common, there are clinical situations where billing both is certainly appropriate. BPP is a test of fetal well-being, with specific elements included in its description. A limited ultrasound study is usually done for fluid check, viability, placenta evaluation, and/or presentation. Evaluation of the placenta or presentation are not included in a BPP evaluation. If you have an indication to do a BPP and a distinct indication to do a limited study (placenta or presentation), billing a BPP and a limited study would be appropriate in those situations. Similarly, a follow-up study 76816 can also be billed with a BPP if there is a distinct indication for each. On the other hand, billing for 76816 + 76815 would never be appropriate because all the elements of a limited study would be included in a follow-up study. Some payers may restrict you from billing 76815 or 76816 along with a BPP. This would be unique to that payer and should not be generalized to all situations.
Hope this helps.
Fadi
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Fadi Bsat, MD
Past Chair, SMFM Coding Committee
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Original Message:
Sent: 07-16-2020 21:20
From: Dimitry Zilberman
Subject: Bpp and Limited
76815 is usually billed alone. If there is another indication for ultrasound 76816 is used. 76820 for umbilical artery Doppler.
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Dimitry Zilberman
Original Message:
Sent: 07-15-2020 18:10
From: David Jones
Subject: Bpp and Limited
Good day.
You cannot generally bill a 76815 and 76818 together as the BPP includes most of the 76815. You could bill a 76816 if there was reason to do a follow-up in addition to a BPP, but not a limited.
Best regards,
David C Jones, MD
Director, University of Vermont Medical Center Fetal Diagnostic Center
Professor, Obstetrics, Gynecology & Reproductive Sciences
University of Vermont
Dept of Obstetrics, Gynecology & Reproductive Sciences
Division of Maternal-Fetal Medicine
(802) 847-5698
Original Message:
Sent: 7/15/2020 9:16:00 AM
From: Monica Dowdell
Subject: Bpp and Limited
Good morning
In my practice the question has been raised about billing a bpp and a limited with IUGR patients. Are you able to bill both. I did not find a CCI edit but I wanted to confirm if the need is felt for a further review would a limited be appropriate or a follow up?
I thank you for your time.
Monica
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Monica Dowdell
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