Wiki OB vs. Non-OB Ultrasound

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cwpierce

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This is a bit of a brain teaser for me so I will post my line of thinking. I had a Doctor call to ask which US code to use in the situation of a patient being seen for amenorrhea (626.0). The doctor does an ultrasound and comes back with a threatened abortion dx (640.03).
I'm thinking ok, we bill for an OB ultrasound but then the doctor says that she didn't see a fetus. Well now, if there is no fetus then how can we be using a dx of 640.03 when there is nothing there to be threatened? Maybe the doctor means a missed abortion (632)...but I'm still awaiting a chance for futher discussion with the doctor about this. In the meantime, if it is truely a missed abortion would I use an OB ultrasound code with a screening dx (v28.8x) and a missed abortion dx of 632...... or ...... because there is no fetus, use a Non-OB ultrasound code and use the amenorrhea dx of 626.0? Basically, which ultrasound is coded if it is our first ultrasound and we find that the patient was pregnant but miscarried before she ever stepped into the office for her missed periods?


Thanks for any help on this one.
 
I would code a non OB us w/ primary dx of amenorrhea and 2nd dx of missed Ab since she was primarily seen for amenorrhea.
 
I would politely givemy openion as this:
the doctor has ome out with the final diagnosis ( uptill then) as" threatened abortion". I am sure the doctor for this particular case, did not label yet as missed abortion.
As I said in the other post,
still the evidence is incomplete to label as missed abortion. By the way all cases are generally ammenorrhoea including pregnancy as physiological ammenorrheoa. Once pregnancy is confirmed/ or fetal gestational sac or fetal poles are diagnoses , it is a pregancy.
The point i would like to emphasiszze is for unltrasound perspective, i tis a OB Utrasound.
I am aware of the fact that for text book categorization missed aborion, ectopic pregnancy, blighted ovum can be placed in both OB or Gyn. That is ot our point now for ultra sound placement.
 
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