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New 3D ultrasound codes are not for routine use

Q Is there a code for a 3D gyn ultrasound, for example, to detect endometriosis? Or can you only bill the 76856 code (ultrasound, pelvic [nonobstetric], B-scan and/or real time with image documentation; complete)?

A As it happens, CPT added new codes this year to allow billing for 3D ultrasound: 76376 and 76377 (right). The 3D code is billed in addition to the basic service, which in your example is 76856. However, keep in mind that many payers still consider 3D investigational and will not pay without strong medical necessity. You should not be routinely billing for this technology.

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Melanie Witt, RN, CPC-OGS, MA
Independent coding and documentation consultant; former program manager, Department of Coding and Nomenclature, American College of Obstetricians and Gynecologists

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Melanie Witt, RN, CPC-OGS, MA
Independent coding and documentation consultant; former program manager, Department of Coding and Nomenclature, American College of Obstetricians and Gynecologists

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Melanie Witt, RN, CPC-OGS, MA
Independent coding and documentation consultant; former program manager, Department of Coding and Nomenclature, American College of Obstetricians and Gynecologists

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Q Is there a code for a 3D gyn ultrasound, for example, to detect endometriosis? Or can you only bill the 76856 code (ultrasound, pelvic [nonobstetric], B-scan and/or real time with image documentation; complete)?

A As it happens, CPT added new codes this year to allow billing for 3D ultrasound: 76376 and 76377 (right). The 3D code is billed in addition to the basic service, which in your example is 76856. However, keep in mind that many payers still consider 3D investigational and will not pay without strong medical necessity. You should not be routinely billing for this technology.

Q Is there a code for a 3D gyn ultrasound, for example, to detect endometriosis? Or can you only bill the 76856 code (ultrasound, pelvic [nonobstetric], B-scan and/or real time with image documentation; complete)?

A As it happens, CPT added new codes this year to allow billing for 3D ultrasound: 76376 and 76377 (right). The 3D code is billed in addition to the basic service, which in your example is 76856. However, keep in mind that many payers still consider 3D investigational and will not pay without strong medical necessity. You should not be routinely billing for this technology.

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OBG Management - 18(06)
Issue
OBG Management - 18(06)
Page Number
92-95
Page Number
92-95
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New 3D ultrasound codes are not for routine use
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New 3D ultrasound codes are not for routine use
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