I have a question regarding coding 76811 versus 76805 for MFM. there has been question in our clinic....
1) For our clinic, being a specialty clinic, we automatically perform a level II full fetal anatomy Ultrasound 76811 on our patients, unless; of course they are under 18 weeks gestation... but if they have just anatomical scan with no other diagnostic reason for that scan, we bill for a 76805 instead even though the report shows we performed the 76811. could that be billed correctly as 76805 with diagnosis code Z36.89?
2)If the fetus ends up being large for dates, (O36.69X0) where the fetus measures at 90% or greater, my Doc feels that is not adequate to bill a 76811 with LGA diagnosis and should code a 76805 instead. Is LGA diagnosis (O36.369x0) a reasonable DX to bill with 76811?
I could use some input regarding these 2 questions.
thank you,
Sheila
1) For our clinic, being a specialty clinic, we automatically perform a level II full fetal anatomy Ultrasound 76811 on our patients, unless; of course they are under 18 weeks gestation... but if they have just anatomical scan with no other diagnostic reason for that scan, we bill for a 76805 instead even though the report shows we performed the 76811. could that be billed correctly as 76805 with diagnosis code Z36.89?
2)If the fetus ends up being large for dates, (O36.69X0) where the fetus measures at 90% or greater, my Doc feels that is not adequate to bill a 76811 with LGA diagnosis and should code a 76805 instead. Is LGA diagnosis (O36.369x0) a reasonable DX to bill with 76811?
I could use some input regarding these 2 questions.
thank you,
Sheila