Wiki Ob/gyn

[Kathy Leff]

OB/GYN

Can you bill for CPT 93975 duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs, complete study along with 7680176830 on a routine basis. My physician is doing the duplex scan routinely with all ultrasounds but I don't believe it should be routinely billed separately. Any help would be appreciated.

 

[ajs]

OB/GYN

Can you bill for CPT 93975 duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs, complete study along with 7680176830 on a routine basis. My physician is doing the duplex scan routinely with all ultrasounds but I don't believe it should be routinely billed separately. Any help would be appreciated.

I would not think this would be a routine exam in OB/Gyn. The 93975 is a complete arterial study of the pelvic region in relation to a blockage, is there documentation of a possible blockage or some sort of risk factors?

The description of 76801 is a complete ultrasound of a first trimester uterus and fetus with very specific measurements and identifiers required. I am not sure why an OB/Gyn would be doing additionally a complete vascular study of the pelvic region at the same time. Also be aware that 76830 is not an obstetrical code but is a transvaginal ultrasound of a non-pregnant patient. If he is doing transvaginal of the pregnant uterus then use 76817. But there needs to be a reason for doing the transvaginal and the transabdominal at the same encounter.

I am guessing your provider went to a seminar somewhere and learned that if he always coded the duplex scan with the other ultrasounds he would get more money. The documentation must validate that both types of exams were done, and that there was medical necessity for doing that level of service. I would be auditing some charts before the insurance carriers come by to check it out!

 

[Kathy Leff]

Thanks for your review. Diagnoses include both OB and GYN visits. Most frequently billed diagnosis for OB is high risk pregnancy without specifics. I concur for your comments.