# Nst - Does anyone know where I can find



## pennyann111

Does anyone know where I can find documentation requirements for billing out Non Stress Tests?  I am sure somewhere I read something on this but cannot seem to recall.  I have a doctor who I need to get this info to quickly.
Thanks


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## yt

From Society of Maternal Fetal Medicine website.

Date: 6-10-2008

There is a difference in just placing a patient on a monitor to see if she is contracting versus performing a complete NST. When billing for a NST (59025), the following must be included in your final interpretation.

Patient Name
Date of Service
Gestational Age
Diagnosis
Indication for test
Interpretation (eg. reactive, non-reactive, reassuring)
Fetal Heart Rate Baseline
Periodic Changes
Recommended Follow-up
Physician Signature

If this is provided in the hospital, the Modifier-26 (Professional Component Only) should be appended to the NST (59025). If the test was performed in your office setting and it is deemed a "free standing clinic setting", thus services reported under the a place of service of 11, then you would be reporting the full component.

The CPT Code 59050 is reported for fetal monitoring during labor by consulting physician (i.e., non-attending physician) with written report; supervision and interpretation with written report; supervision and interpretation.

The CPT Code 59051 would be reported for the interpretation only for fetal monitoring during labor by consulting physician (i.e., non-attending physician)


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## sugihara

What about fetal monitoring when the mother is not in active labor?

~Kelli S.


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## preserene

nonstress test  (NST) the monitoring of the response of the fetal heart rate to fetal movements by cardiotocography.  In other words, a noninvasive test is a monitoring test  in which fetal movements are monitored and recorded, along with changes in fetal heart rate.
[That is to explain:  As the pregnancy progresses, the doctor will continue to check the fetal heart tones and will eventually schedule the mother for a non-stress test. The non-stress test (NST) monitors the fetal heart rate at the same time a toco transducer measures the mother's uterine contractions. Late in pregnancy, the uterus contracts – even though the mother cannot feel contractions – and the baby responds to these gentle contractions. The NST checks for a healthy fetal response to these contractions.]
The one done during labor is called PARTOGRAM. It is a programmed labor, a part of indeginous protocol to optimize labor outcome- depicting the picture the relation and the outcome of cervical dilation, fetal heart rate and the uterine contraction in timely fashion.
  Partography denotes the graphic representation of cervical dilation on atimed scale time curve of labor.When patient in labor, the consulting physician has to monitor and write report  (CPT CODE 59050),
 When the consult is requested to  for interpretation of the partograph , the code 59051 appropriates.
The NST can be done by attending Physician and reported with 59030.
So Sugihara, the NST is the monitoring (recording) of uterine contraction and the Fetal heart rate  and its response to the uterine contraction, when the patient is not in active labor.


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## jon.lardizabal

Is NST the same as the normal/regular fetal heart monitoring done during delivery? Pretty much all deliveries involve some form of FHR monitoring, does this mean we code this every single time?


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## khines80

*FNST - Documentation Requirements*

@pennyann111 - Yes, look at this website: http://www.hcpro.com/content.cfm?dp=HIM&content_id=275167

FNST documentation requirements - done at 28 weeks or more gestation 

The clinical FNST documentation needs to include four elements to be coded and billed.
1.Clinical indication, for example decreased fetal movement, IUGR, gestational diabetes, gestational hypertension, vaginal bleeding or spotting, pre-eclampsia, etc.
2.Interpretation, for example fetal heart tones (FHT) show a baseline of 130 bpm with 10x10 accelerations and moderate variability, reactive with no decelerations.
3.Time noted, for example that a patient was monitored for a certain number of minutes or hours through the course of the stay.
4.Signature and authentication.


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## khines80

*NST is NOT the same as the normal/regular fetal heart monitoring done during delivery*



jon.lardizabal said:


> Is NST the same as the normal/regular fetal heart monitoring done during delivery? Pretty much all deliveries involve some form of FHR monitoring, does this mean we code this every single time?



A Fetal Non-Stress Test (CPT 59025) during pregnancy is a method for checking whether the baby is healthy and is growing well. This is usually done at 28 weeks or later. This test monitors the ability to deliver naturally, if the mom's had diagnoses that may or have complicated the pregnancy/delivery. It is important to monitor whether the patient is capable of delivering a baby naturally. If the pregnancy has complications, then doctors can advise a C section.

CPT codes 59050 and 59051 fetal monitoring during labor are included in the code for vaginal or C-section delivery and are not separately reportable. This fetal monitoring is used to check the baby's heart rate to keep tabs on how well they are doing and how they are tolerating the contractions.


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