Ob-Gyn Coding Alert

Can you report ultrasounds separately from the global package? Here's the official word from both the AMA and the American College of Obstetricians and Gynecologists (ACOG).

Although many insurance providers include ultrasounds (76801-76802 or 76805-76810) as a standard part of the ob global package (for example, 59400, Routine obstetric care including antepartum care, vaginal delivery [with or with episiotomy, and/or forceps] and postpartum care), CPT maintains otherwise. "Antepartum care includes the initial and subsequent history, physical examinations, recording of weight, blood pressures, fetal heart tones, routine chemical urinalysis, and monthly visits up to 28 weeks gestation, biweekly visits to 36 weeks gestation, and weekly visits until delivery," CPT states. "Any other visits or services within this time period should be coded separately."

In addition, the AMA has stated that the ob global package does not include diagnostic ultrasound, according to CPT Assistant April 1997.

The American College of Obstetricians and Gynecologists (ACOG) also upholds this advice. "Some payers, however, include one or more ultrasounds in the global care," warns Peggy Stilley, CPC, CPC-I, COBGC, ACSOB, clinic manager for the University of Oklahoma in Tulsa.

Best bet: Check your payer's policy. It may or may not follow ACOG and the AMA's advice.

Learn more: Refer to "Multiple Ob Ultrasounds? Recoup More Than $120 That Your Practice Deserves" featured in Ob-Gyn Coding Alert, Vol. 12, No. 12.