Coding for Ultrasound Guidance in Obstetrics
The use of ultrasound to guide procedures in obstetrics is common. In addition to the relevant primary procedure code being performed, additional separate coding for ultrasound guidance, depending on the procedure type and setting, should be included and reflected in the documentation. The following codes and examples provide guidance on proper coding for ultrasound guidance in the obstetric and MFM setting:
Amniocentesis76946 Ultrasound guidance for amniocentesis, imaging supervision and guidance.
When submitting for reimbursement, please note you would also submit the 59000 code (for the actual amniocentesis) with the ultrasound guidance code.
CVS76945 Ultrasound guidance for CVS, imaging supervision and guidance.
When submitting for reimbursement, please note you would also submit the 59015 code (for the actual CVS) with the ultrasound guidance code
Fetal Transfusion or Cordocentesis
76941 Ultrasound guidance for fetal transfusion or cordocentesis, supervision and interpretation2.
Needle placement76942 Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation.
Examples include: fetal intracardiac injection, intraamniotic injection.
If ultrasound is performed intraoperative and/or no specific code exists, report:
Intraoperative guidance
76998 Ultrasound guidance, intraoperative.
Examples: Guidance during ECV, cerclage, placement of cervical dilators, D&C, D&E.
Alternative: 76999 unlisted ultrasound procedure (e.g., diagnostic, interventional).
For other procedures, ultrasound guidance may be included in the ultrasound code and should not be reported separately.
For example, the following fetal surgery codes include ultrasound guidance:
• 59070 Transabdominal amnioinfusion, including ultrasound guidance
• 59072 Fetal umbilical cord occlusion, including ultrasound guidance
• 59074 Fetal fluid drainage (e.g., vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance
• 59076 Fetal shunt placement, including ultrasound guidance
• 59897 Unlisted fetal invasive procedure, including ultrasound guidance