Practice Management Alert

Question: We had an all-staff meeting at our OB-GYN office last week. Our director of coding talked about a couple of new codes coming out in 2016, specifically, a new OB panel code and MRI changes. Could you elaborate on both of these changes so we can update our charge sheets before January?

North Dakota Subscriber

Answer: Your coding director was referring to the new coding option for an obstetric panel and two new codes for fetal magnetic resonance imaging). You will have 80081 as a new option for coding obstetric panel (see detailed descriptor in box below):

The difference: This code is similar to the OB panel code 80055 (Obstetric panel...), but 80081 includes “HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies, single result (87839).”

No matter which code you choose for your panel, all 80055 and 80081 claims must include all of the elements listed in the descriptors.

Fetal MRI update: CPT^® 2016 will also include a pair of new fetal MRI codes your OB-GYN office might find handy. Use 74712 (Magnetic resonance [e.g., proton] imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation) or 74713 (… each additional gestation [List separately in addition to code for primary procedure]) for fetal MRIs when the encounter calls for these codes.

Remember, in order to use 74712 and/or 74713, you need to prove medical necessity. A fetal MRI could be necessary when:

• the ultrasound reveals an abnormality that the physician cannot define;
  
• the ultrasonography identifies an abnormality, and the physician needs more information, in the form of a fetal MRI, to decide a course of care; or
  
• the physician feels that the fetus is at risk for abnormality, even though she finds no definitive markers from the ultrasound.