Coding, Classification and Reimbursement

Viable pregnancy

  • 1.  Viable pregnancy

    Posted 01-03-2019 21:47
    Please give me you advice on this scenario.

    First obstetrics ultrasound scan confirmed a viable pregnancy with all parameters met. MD recommended to consider NT scan. How would you best code for this with no other indication present.

    Then:

    First obstetrics ultrasound scan confirmed the fetal pole was not visualized and therefore mother must  follow up in one week for another scan to determine viability.


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    Sharmilla Rabin
    Medical Billing Specialist
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  • 2.  RE: Viable pregnancy

    Posted 01-03-2019 22:38
    ​HI!
    I would code the Inconclusive Pregnancy as ICD 10 CM  Dx (diagnosis) code : O)36.80X0 - unspecified or not applicable. You should always confirmed the diagnosis by doing a query from the PCP or Provider. Regardless of the Ultrasound statement, it has to be the provider who makes the call of the actual pregnancy. Ifs it conflicts with the Radiologist on the Ultrasound, then you need to do a query for exact confirmation to be documented in the patients' medical record.

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    Charisse Smith
    Senior Him Consultant (Auditor)
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