Ob-Gyn Coding Alert

Question: When an umbilical Doppler is done on a fetus for possible placental insufficiencies, what code do you recommend?

Renay Casy, CPC, LA

Answer: Generally speaking, the code 76827 describes Doppler of the fetal cardiovascular system and usually this means that up to two arteries are examined. The umbilical and uterine arteries are the most common ones examined. Therefore, the code 76827 would be the most accurate code to describe Doppler examination of the umbilical artery. The diagnostic code in this case is harder to pick. You cannot code directly for possible placental insufficiency, because the diagnostic code category is 656 (other fetal and placental problems affecting management of mother). This category does not include the words known or suspected, therefore, you can only use a code from this category when you have a definite diagnosis. You would have to code for any symptoms the mother is having, for fetal heart rate anomalies, or a history of a problem in a previous pregnancy that might lead the physician to believe there is a problem with this one.