# Modified fetal biophysical profile



## klcampbe (Feb 18, 2010)

We have providers performing a modified BPP, where an ultrasound for amniotic fluid volume index is combined with an NST.  I am hearing conflicting information about how to code for this service.  Some recommend reporting 76815 with 59025, and others recommend reporting the BPP (76819).  Any recommendations?


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## imjsanderson (Feb 18, 2010)

76818 is a BPP with NST, have you looked at this code?


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## klcampbe (Feb 18, 2010)

Yes, I've looked at that code.  The problem, is they aren't doing 3 of the other 4 parts of the test.  A BPP requires 1) fetal trunk and extremity movement; 2) fetal tone; 3) fetal breathing movement; 4) amniotic fluid volume;.  They only do the AFI with the NST, so I'm not sure that I can report the BPP with NST.

Thanks for your help.


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## cjbrock (Mar 1, 2010)

If they only do an AFI then I would code a brief u/s 76815 along with the nst 59025.


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## ajfreeba (Mar 2, 2010)

Given the paranthetical note following code 76819 "(for AFI without non-stress test, use 76815)," and Meciare's CCI edit which precludes the reporting of 76815 and 59025 together unless performed during separate encounters, I would not recommend following the above recommendation to report these codes for the service. 

I do note the CPT Assistant articles which seem to clearly show that 76818 may not be repoorted without the performance of what they call the five key components; however, given the lack of direction on which code to use, I would consider 76818 with a -52 modifier.


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