Journalists working on stories related to high-risk pregnancies or the Society for Maternal-Fetal Medicine can contact Greg Phillips, Director of Communications, at press@smfm.org for referrals to MFM experts and to request additional information. The press office is open Monday through Friday from 9:00 AM to 5:00 PM ET.
When an invasive antenatal procedure is performed, confirmation of the fetal heart beat or a systole post procedure is in included in the work of the procedure and should not be billed separately. Invasive Antenatal Procedures: 1. 59000 Amniocentesis; diagnostic and 76946 Ultrasonic... Continue Reading
A recent question was asked on the correct way to report an Umbilical Cord Occlusion via the Radio Frequency Ablation approach”. Below you will find two examples of multi-fetal reductions, their approach and correct coding guidance for billing purposes. Types of Fetal Reductions and... Continue Reading
Some payers have frequency guidelines related to Obstetrical ultrasound services, and will only pay for a certain number of scans per pregnancy, regardless of diagnosis and complications, provider specialty or practice tax ID. It is important to be aware of these contractual restrictions, and... Continue Reading
99446 Interprofessional telephone/Internet assessment and management service provided by a consultative physician including a verbal and written report to the patient's treating/requesting physician or other qualified health care professional; 5-10 minutes of medical consultative discussion and... Continue Reading
The National Uniform Claim Committee (NUCC) has approved a transition timeline for the version 02/12 1500 Health Insurance Claim Form (also known as CMS-1500).In June, the NUCC announced the approval of the updated paper 1500 ClaimForm that accommodates reporting needs for ICD-10. The new 1500... Continue Reading
A consultation is a type of service provided by a physician whose opinion or advice regarding Evaluation and Management (E/M) of a specific clinical problem is requested by another physician or other appropriate source. CPT consultation guidelines further define an “appropriate source”... Continue Reading
Chorionic Villus Sampling (CVS) is a prenatal test that detects chromosomal abnormalities such as Down syndrome, as well as a host of other genetic disorders.CVS is a diagnostic procedure which involves removing some chorionic villi cells from the placenta at the point where it attaches to the... Continue Reading
Multiple scans may be billed on the same patient for the same date of service, as long as they are medically necessary and documented appropriately. Below are some examples on how to report the scans based on locations:Ultrasound performed at the office POS 11:768xx with No ModifierUltrasound... Continue Reading
A variety of cell-free DNA (cfDNA) analysis methods have been developed to test for fetal trisomies in maternal blood. These tests fall into two categories: · Random Sequencing and · Directed DNA Analysis. Random sequencing analyzes a random subset of cfDNA... Continue Reading
Recently, a question was posed on the appropriate way to report coding combination 76821 and 76815. Some insurance companies are denying 76815 “incidental” to 76821. Does using a modifier prevent this coding combination from being denied?According to Medicare National Correct Coding... Continue Reading
The SMFM Coding Committee frequently receives questions on the appropriate way to report and receive reimbursement when ultrasound services are provided to hospitalized patients.Global Billing-services are provided and can be billed as Global only when the practice:* owns or leases the equipment,... Continue Reading
In the ever changing world of health care and overall rising costs, co-payments are no longer ONLY applied for certain specialties and are NOT always driven by Place of Service or E&M Visits. The industry has increased cost shifting from insurance plan to patient creating a more self-pay... Continue Reading
