When ICD-10 is implemented in October, 2015, a significant change for MFM will be the ability to assign a condition to a specific fetus in multiple gestation pregnancies. This is done using a 7th character on the ICD-10 code for certain categories. The designations are: 0 = not applicable or... Continue Reading
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CPT code 93975 describes duplex scan of arterial inflow and venous outflow of abdomen, retroperitoneum, scrotal contents and/or pelvic organs. This code applies to a complete evaluation, and may be used whether single or multiple organs are studied. It is a "complete" study, in that all major... 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
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
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
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
The CPT 76811 (Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination) is not intended to be the routine scan performed for all pregnancies. Rather, it is intended for a known or suspected fetal anatomic, genetic... Continue Reading
This White Paper will deal with the “Radiology Bundling Rule” (RBR) to provide the SMFM Coding Committees recommendations for the optimal reporting and obtaining proper reimbursement for multiple obstetrical ultrasounds performed on the same day with special focus on avoiding second... Continue Reading
Dear Members, and Coders,This White Paper will deal with this subject and give, to the best of this Committee knowledge, what the appropriate way of billing and obtaining reimbursement for such services. Download the PDF Continue Reading