Ultrasound Frequency and Taxonomy Codes
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 try to negotiate additional coverage for patients with pregnancy complications, who require more frequent and involved services.
When a Maternal-Fetal Medicine Specialist and OB Generalist are in the same practice and share the same Tax ID Number, it is important to note the correct Taxonomy Code for each provider (listed below). The Taxonomy Code delineates the sub-specialty of MFM from the OB Generalist, even when billing under the same Tax ID Number. This may help avoid unnecessary denials in cases where the payer frequency guidelines are based on the number of scans performed by the same practice.
MFM Taxonomy Code = 207VM0101X
OB GYN Taxonomy Code = 207V00000X