Ob-Gyn Coding Alert

Question: Our ultrasound sonographers want to bill 76801 at the same time they perform and bill for a nuchal translucency (76813). They say they perform all the components of 76801 in addition to the requirements for 76813. They use the same diagnosis code (V28.3, Screening for malformation using ultrasonics) for both. Can we bill two ultrasound codes at the same time?

Virginia Subscriber

Answer: Yes, you can report 76801 (Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester [< 14 weeks 0 days], transabdominal approach; single or first gestation) and 76813 (Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation) at the same time.

Note: Most payers do not normally require modifier 51 (Multiple procedures) for ultrasound procedures.

The National Correct Coding Initiative (NCCI) does not bundle this code combination. And the American College of Obstetricians and Gynecologists (ACOG) indicates that you can report these codes together. But this does not guarantee payment. Check with your payers to learn their policies in this situation.