Multi‐society guideline for coding, billing, and clinician training for detailed fetal anatomy ultrasound in the first trimester

Multi-society guideline for coding, billing, and clinician training for detailed fetal anatomy ultrasound in the first trimesterIt is crucial to emphasize the significance of reimbursing Detailed First-Trimester Ultrasounds (DFTUs) and the proposed adjustment to the guidance for CPT R code 76811, traditionally associated with second-trimester ultrasounds.Historically, this code has been restricted to one examination per pregnancy, a limitation acknowledged by medical societies and underscored by payor policies.However, in light of evolving medical practices and the consensus among major imaging and women's health organizations, there is a compelling need to adapt this code for dual utilization during pregnancy.This change not only facilitates the provision of essential DFTUs but also contributes to reproductive health access in the current healthcare landscape.Furthermore, recognizing the pivotal role of physicians in ensuring access to DFTUs is essential.Physicians play a crucial part in making these services available, and equitable access can only be achieved through proper reimbursement.Adequate payment not only encourages healthcare professionals to enhance their skills but also motivates them to seek continuous education, ultimately raising the standard of care and expanding access for individuals seeking reproductive health services.

Publication Details

Journal
Pregnancy
Published
2025-06-16
DOI
https://doi.org/10.1002/pmf2.70056
Citations
2
Primary Topic
Prenatal Screening and Diagnostics
Type
article
Field-Weighted Citation Impact
6.99
Controls
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article

Multi‐society guideline for coding, billing, and clinician training for detailed fetal anatomy ultrasound in the first trimester

2 citations
Pregnancy
Prenatal Screening and Diagnostics
6.99
article

Multi‐society guideline for coding, billing, and clinician training for detailed fetal anatomy ultrasound in the first trimester

article en
2 citations

Abstract

Multi-society guideline for coding, billing, and clinician training for detailed fetal anatomy ultrasound in the first trimesterIt is crucial to emphasize the significance of reimbursing Detailed First-Trimester Ultrasounds (DFTUs) and the proposed adjustment to the guidance for CPT R code 76811, traditionally associated with second-trimester ultrasounds.Historically, this code has been restricted to one examination per pregnancy, a limitation acknowledged by medical societies and underscored by payor policies.However, in light of evolving medical practices and the consensus among major imaging and women's health organizations, there is a compelling need to adapt this code for dual utilization during pregnancy.This change not only facilitates the provision of essential DFTUs but also contributes to reproductive health access in the current healthcare landscape.Furthermore, recognizing the pivotal role of physicians in ensuring access to DFTUs is essential.Physicians play a crucial part in making these services available, and equitable access can only be achieved through proper reimbursement.Adequate payment not only encourages healthcare professionals to enhance their skills but also motivates them to seek continuous education, ultimately raising the standard of care and expanding access for individuals seeking reproductive health services.

PregnancyVol. 1(4)
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Openalex Percentile: Top 4%
Prenatal Screening and Diagnostics
6.99
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