US Question - How long should the Diagnostic US take?

[khaoskat]

Ok, I know this may be stupid, but I have never in my 4 pregnancies have as short of a diagnostic US as the one I had today. (Should probably mention this is a pregnancy that occurred less than or at almost exactly 3 months from the termination by full term still birth at 40 w 2 d gestation of my previous pregnancy.)

I literally reviewed the tape I purchased....and from start to finish (give or take a few seconds) it lasted a whole of 8 minutes. There were no "in depth" looks at anything, they noted the presence of the heart, kidneys, bladder (the last two taking like a 2 second look at each). The heart was a bit longer, because the tech did a few screen captures and had to wait for them to save before moving on. There were no close ups of the heart or any other organ.

Other than that, she measured the 3 typical top of skull measurements, measured the circumfrence of the abdomin and the length of the femor bone in one of the legs. She also looked at my ovaries and cervixs in this short amount of time.

Heck, she is moving so fast on the US machine, you can barely make anything out on the video, except where she stopped for a few seconds to do a quick save of a screen capture. You cannot even see anything in the 4 pics that were taken. Everything was done in 2d.

This was not done at my OB's office, but part of a large group who does US's for most of the OB's at the hospital and also co-manages high risk pregnancies. Their own in office OB's will review everything and then send a report to my OB's.

I am just having a hard time believing that they can do a thorough job on a diagnostic us in that short of a time w/o even examining any of the organs. Of my 4 pregnancies (and 5 diagnostic US's during that time, this by far was the shortest...most of them were at least 30 minutes with 2 of them being about 45-60 mins.)

I just looked at the billing it was for a Greater than 1st tri "detailed" US.

[Paige, CPM]

Khaoskat,

First let me express much sympathy to you for what I imagine is a difficult time for you.

I am sorry someone wasn't able to post a good answer for you.

I have never seen a u/s done that quickly either. I might have the same questions you are having if it were me, ESPECIALLY considering your history.
Was the sonographer aware of your recent loss?

I would definatley talk to your provider about this situation and perhaps request another more in depth sono, for no charge of course.

I hope you can come to some conclusion about this, please share if you would like as too I am curious as to why the proceedure was done so quickly.

All the best, Paige

[khaoskat]

Thanks.

No, she was not aware of my history. She specifically asked me if there had been any chagnes since I was last there...the only US I had with them other than this one, was the Nuchal at 13 weeks.

I looked over my bill, and she put down the US as CPT 76811 - Greater than first tri "detailed" US, rather than CPT 76805 - Greater than first tri US. I looked up the CPT code for 76811 and this is what I have found on it...

2006 Coding Symposium — Follow Up Questions — OB Coding




Question:

I attended your OB presentation last week at the Symposium last week in Wisconsin and I have a question about the correct code(s) to use for "routine" OB ultrasound. Under what circumstances would 76811 be appropriate? It is my understanding that this code is to be used when there is the possibility of fetal anatomic or genetic abnormality and should not be used as the routine exam. A routine DX code (V22.1) would not be appropriate.



Answer:

We found the following information in the CPT Asst March 2003. As you can see this is going to be if there is an elevated risk of congenital abnormality, extensive studies and a detailed anatomic survey.

"CPT codes 76811 and 76812 were added for CPT 2003 to describe an extensive fetal ultrasound evaluation and detailed anatomic survey required for pregnancies at elevated risk of congenital abnormalities of fetal development (birth defects). They also describe maternal uterine and adnexal evaluation.

76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation
76812 each additional gestation (List separately in addition to code for primary procedure)
The above codes include all of the elements described in codes 76805 and 76810. In addition, a detailed anatomic evaluation of the fetal brain/ventricles, face, heart/outflow tracts and chest anatomy, abdominal organ specific anatomy, number/length/architecture of limbs and detailed evaluation of the umbilical cord and placenta and other fetal anatomy as clinically indicated must be documented and reported.

The results of the evaluations of those elements described on the previous page or the reason for non-visualization should be documented adequately in a signed written report."

CPT code 76805 to describe the initial screening U/S
(Figure 1). This code is specific for a transabdominal U/S performed after the first trimester and
includes measurements and evaluation of fetal anatomy appropriate for the gestational age.

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I have no clue on this, I did call my OB's office, and because they hadn't had the report back they couldn't help much, but put a call in to get the report. When they called down (the nurse called me back about it), the perinatology group took my name and number and said they would have the tech call me back. Well, I received 2 calls from (area code) 000-0000, which is the hospital, but my OB's office comes up with that, as well as Help Me Grow, the Birth Center, and patient financial. Whomever called didn't leave a message.