Ob-Gyn Coding Alert
Only Reviewed Ultrasound? Find Out If You Can Use Mod 26
Question: Patient had 76815 (Ultrasound, pregnant uterus, real time with image documentation, limited [eg, fetal heartbeat, placental location, fetal position and/or qualitative amniotic fluid volume], 1 or more fetuses) and 76819 (Fetal biophysical profile; without non-stress testing) done on 1/5/19 (with breech presentation) as well as 76805 (Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester [> or = 14 weeks 0 days], transabdominal approach; single or first gestation) and 76700 (Ultrasound, abdominal, real time with image documentation; complete) (due to flank pain, with cephalic presentation) on 1/20/19 (both performed in the hospital). I’ve read in the archives that the doctor would need to interpret the report and write a formal report in order to bill for professional component (modifier 26). If our doctor merely reviews, then I’m assuming nothing can be billed? Texas Subscriber Answer: Correct. A review would constitute medical decision-making, not the professional interpretation and written report.
Related Articles
Ob-Gyn Coding Alert
- Obstetrics:
5 Tips Will Transform Your Tubal Ligations Into Ethical Reimbursement
Do you know when to apply modifiers 51, 52? Find out. When a patient no [...] - Injections:
Are You IM Injection Coding Proficient? Find Out with 3 Q&As;
CPT® guidelines focus on whether the ob-gyn is present. Here’s why. When you get ready [...] - Mythbusters:
Bust These 4 Myths to Achieve Aftercare Coding Perfection
Here are the codes you’re most likely to see in your ob-gyn practice. When you [...] - You Be the Coder:
Complication from Previous Surgery Scenario
Question: A patient presents with a complication from a previous surgery which was a laparoscopy [...] - Reader Question:
Patient's Employer Requesting Labs? Look to These Z Codes
Question: What diagnosis code would I use if the patient is requesting labs for work? [...] - Reader Question:
Report FBR by How Ob-Gyn Got It Out
Question: My physician removed a foreign body from the vagina of a 4-year-old using a [...] - Reader Question:
You Cannot Separate Some Bundles
Question: We have a physician who performed a 44180 (Laparoscopy, surgical, enterolysis (freeing of intestinal [...] - Reader Question:
Check Out These Reqs for Fetal MRI
Question: What are the requirements for a fetal MRI? Codify Subscriber Answer: Your question is [...] - Reader Question:
All O Codes Will Require Gestational Age
Question: If a patient says she has a complete AB, do we need to list [...] - Reader Question:
Count Hemostasis as Part of Procedure
Question: Patient is one day post-op for 58548 (Laparoscopy, surgical, with radical hysterectomy, with bilateral [...] - Reader Question:
Only Reviewed Ultrasound? Find Out If You Can Use Mod 26
Question: Patient had 76815 (Ultrasound, pregnant uterus, real time with image documentation, limited [eg, fetal [...]
