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Reimbursement Advisor


How to use new codes for 3D ultrasound

April 2006 · Vol. 18, No. 4

<huc>Q</huc> How should I bill a 3D ultrasound of the fetus?

<huc>A</huc> Keep in mind that most payers still consider 3-dimensional fetal ultrasound an expensive “new science” that is not being reimbursed. Be sure that you have a sound medical indication for 3D ultrasound, and be sure that the patient is made aware that this procedure may not be covered by her insurance company.

Two new codes represent 3D rendering of an ultrasound.

  • Code 76376 is reported in addition to the basic service (detailed obstetric ultrasound 76811) when the image does not require image postprocessing on an independent workstation.
  • Code 76377 is reported if image postprocessing is performed on an independent workstation.

According to CPT guidelines, these 2 codes also require “concurrent physician supervision of the image postprocessing 3D manipulation.” Previously, the only code available for 3D manipulation was 76375, a code that did not mention conversion from an ultrasound. Code 76375 has been deleted from CPT 2006.

Ms. Witt, former program manager in the Department of Coding and Nomenclature at the American College of Obstetricians and Gynecologists, is an independent coding and documentation consultant. Reimbursement Adviser reflects the most commonly accepted interpretations of CPT-4 and ICD-9-CM coding. When in doubt on a coding or billing matter, check with your individual payer.

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