# OB ultrasound dx ?



## Kimberley (May 20, 2009)

What dx code would be appropriate to check size/date, pts are 25+ weeks gestation with no abnormality.

Thanks


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## kumeena (May 20, 2009)

how about normal pregnancy V22.X


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## drdadhichsunil (May 21, 2009)

*dx for ultrasound ob*

hi 

we can code V28.89 FOR SIZE AND DATE OF 25 WKS GESTATION

DR SUNIL DADHICH 
               CPC-A
MUMBAI


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## amelitz (May 22, 2009)

*coding analyst*

Hi,

How about V28.81 (Encounter for fetal anatomic survey)?


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## Joe_coder07 (May 24, 2009)

Hi,

My thought on this we can code this as v28.81.

Joseph Amalraj Antonisamy CPC-H


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## Thirudev (Jun 29, 2012)

*I hope its wrong*

Hi pal,

This V28.81 is an encounter code more over its for anatomy survey, which includes checking for head, limbs, internal organs like heart, intestine, kidney, liver etc., and also spine, brain. 

If all this covered then it will be considered as full fetal anatomy survey.

If I'm wrong, do let me know.

Regards,
Thirudev
CPC, CCS




amelitz said:


> Hi,
> 
> How about V28.81 (Encounter for fetal anatomic survey)?


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## tmlbwells (Jun 29, 2012)

We use V28.3 as well.


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## LJ2009 (Jul 6, 2012)

*76816 & v28.81*



Thirudev said:


> Hi pal,
> 
> This V28.81 is an encounter code more over its for anatomy survey, which includes checking for head, limbs, internal organs like heart, intestine, kidney, liver etc., and also spine, brain.
> 
> ...



dear Thirudev,

Can please you provide your source for your description of V28.81? 

I can not find that ICD-9 differenciates between a limited verses a complete/full survey - it only states V28.81 Encounter for fetal anatomic survey. 

It sounds like you are describing the CPT code for a _complete_ >14 weeks OB US 76805 which includes in it's guidelines the specific elements (10-11) which qualify it as a complete fetal and maternal evaluation verses 76815/76816 limited/follow up, (76816 specifically states: re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ systems suspected or confirmed to be abnormal on a previous scan). 

The same ICD 9 Code V28.81 could be used for both a complete and a limited/follow up ultrasound as the report indicates the level of the detail of the anatomic survey and the purpose of the ultrasound. Whereas the complete CPT 76805 _requires_ documentation in the report consisting of all elements listed in the guideline and could still be a "fetal anatomic survey" {although I think it is more likely that the appropriate ICD 9 would be V28.3 in that case but it would depend on the order and report} the limited/follow up CPT 76815 or 76816 can still be a "fetal anatomic survey" as the purpose is to "survey" the fetal anatomy for growth whether that is one anatomic body area or several. 

The reports I've coded where the patients have come in for fetal anatomic survey's are usually following up a possible abnormality or to specifically check amniotic fluid levels 76815 or for size and date checks 76816 (common in the 2nd and 3rd trimester for size and date checks) and they also include a amniotic fluid measurement - the ICD 9 selection still depends on the purpose of the visit. 

Personally I think that V28.81 is more specific to describe a size and date check than say V28.89 (other specified antenatal screening) or V28.3 (Encounter for routine screening for malformation using US; Encounter for routine fetal US NOS) both of these indicate screening when an encounter/check for size and date check is taking place - however maybe I'm way off here just wanted to share my thoughts and experiences with these. 

here are some of my favorite Radiology resources and associated articles:
http://www.acr.org/
http://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/US_Obstetrical.pdf
http://www.appliedradiology.com/
http://www.appliedradiology.com/uploadedfiles/Issues/1997/11/Articles/v0026i11/00800394/main.pdf


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