# OB Ultrasounds-Twin gestation



## jlv1980 (Sep 8, 2009)

I'm second guessing myself and need input.  I have a patient with twin gestation in for a transvaginal ultrasound which the sonographer has documented as 76817.  I can only charge for the 76817 once as instructions in the CPT shows nothing about using a modifer -59 for the additional fetus, correct?


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## aslonsky (Sep 8, 2009)

just the 76817 is correct for a single or multiple gestation


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## jlv1980 (Sep 8, 2009)

Thank you so much!


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## ajmtucker (Sep 24, 2009)

If you add a modifer 76 to it, you can code 76817 for each fetus


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## aslonsky (Sep 24, 2009)

I am pretty sure that is incorrect. This is ACOG documentation. 

For limited ultrasounds, CPT says to report 76815 once, regardless of the number of fetuses. Similarly, report 76817 only once for transvaginal ultrasound, even when there is more than one gestation.

"The reason for that is that in order to bill this code, the ObGyn must examine the fetus, uterus and other maternal pelvic structures," Rasmussen says. "Even when the ObGyn looks at each fetus separately using this approach, you can only bill the code once because only one evaluation of the uterus, cervix and other maternal structures is performed."


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## ljhaley@gmail.com (Mar 10, 2010)

Would this be the same for 76816? We bill 76816 x2 with 59 mod on the second when twin gestation as it says in the coding book for the transabdominal, "Code also mod 59 for exam of each additional fetus in multiple pregnancy" BUT we keep getting denials even with hardcopy documentation! We didnt used to get denials, and I am using 2010 books, help! THANK YOU!!!


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## srinivas r sajja (Mar 10, 2010)

http://www.obgmanagement.com/pdf/1512/1512OBGM_Adviser1.pdf
hope this helps


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