Check Out Changes to OB Panel, Fetal MRI Coding

Posted on 24 Nov, 2015 |comments_icon 3|By Chris Boucher
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cpt-2016-news-for-ob-gyn-coders

Here’s when you’ll use 80081 for panels.

If you are coding for an OB-GYN office, you should know about a couple of changes coming your way in CPT® 2016.

The skinny: there will be a new OB panel code, and several changes to fetal magnetic resonance imaging (MRI) coding. Read on for a sneak peek at the changes your OB office can expect starting January 1.

Use 80081 when Screen Includes HIV Test

Once CPT® 2016 takes effect, you will have 80081 as a new option for coding obstetric panels (see detailed descriptor in box below):


80081 Descriptor Box

This code is similar to the OB panel code 80055 (Obstetric panel…), but 80081 includes “HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies, single result (87839).”

No matter which code you choose for your panel, all claims containing either 80055 or 80081 must include all of the elements listed in their respective descriptors.

See also: Use Updated Prolonged Services E/Ms to Capture Psychotherapy

Get Acquainted with These Fetal MRI Updates

CPT® 2016 will also include a pair of new fetal MRI codes your OB-GYN office might find handy. Use 74712 (Magnetic resonance [e.g., proton] imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation) or 74713 (… each additional gestation [List separately in addition to code for primary procedure]) for fetal MRIs when the encounter calls for these codes.

Remember, in order to use 74712 and/or 74713, you need to prove medical necessity. A fetal MRI could be necessary when:

  • the ultrasound reveals an abnormality that the physician cannot define;
  • the ultrasonography identifies an abnormality, and the physician needs more information, in the form of a fetal MRI, to decide a course of care; or
  • the physician feels that the fetus is at risk for abnormality, even though she finds no definitive markers from the ultrasound.

Author

Chris Boucher


Chris Boucher has nearly 10 years of experience writing various newsletters and other products for The Coding Institute. His blog will cover several areas of coding and compliance, including CPT® coding, modifiers, HIPAA compliance and ICD-10 coding.

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3 thoughts on “Check Out Changes to OB Panel, Fetal MRI Coding

  1. can any CPT guidance be provided? What is the correct code/s when multiple Fetal MRI images are performed at the same encounter i.e. Fetal MRI of Brain and Fetal MRI of the body (lung lobes). The placenta , cervix and other structures may be imaged too.

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