# Ob ultrasound for twins



## downtownvb (Jul 31, 2014)

Our radiology techs choose the coding for our patients.
Patient came in May 6, 2014. we billed 76805 and 76810 both with dx V91.03.
Patient came back in June 17, 2014 we billed 76816 and 76810 with dx 651.00.
Patient came back in July 15, 2013 we billed 76816 once with dx 651.90.

Report dictation shows normal fetal anatomical survey evaluations on all three visits.

I do not think the coding is correct for followup Ultrasounds. Can anyone help me?


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## OBcoder2017 (Aug 1, 2014)

*twin ob u/s coding*

The V code 91.03 is a status code that requires you to "code first" the multiple gestation code from Chapter 6 651.03.  
If the first ultrasound was done >/= 14 weeks 0 days old, then it was billed correctly with the correct CPT codes 76805 for first gestation, and 76810 for each additional gestation. 76810 is an add-on code.  So this u/s would be billed: 
76805 651.03, V91.03
76810 651.03, V91.03
If the first ultrasound is done </= 14weeks 0 days then you would code using CPT codes 76801 first gestation and 76802 for the additional gestation with the same dx codes.  Add additional complication codes that might arise.

Follow up U/S are to be billed with the appropriate follow up u/s codes, for example the standard follow up u/s is the 76816, but this time you bill the same CPT code twice with a 59 modifier on the second one":
76816        651.03,V91.03
76816-59   651.03, V91.03
Again adding any additional complications that might arise

These rules are as per CPT guidelines and are always paid by my commercial payors.  Hope this helps,


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## downtownvb (Aug 4, 2014)

Thank you.


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