Coding Obstetrical Ultrasounds

Coding Obstetrical Ultrasounds

Aetna considers detailed ultrasound fetal anatomic examination experimental and investigational for all other indications including routine evaluation of pregnant women who are on bupropion Wellbutrin or levetiracetam Keppra , pregnant women with low pregnancy-associated plasma protein A, and pregnant women who smoke or abuse cannabis. There is inadequate evidence of the clinical utility of detailed ultrasound fetal anatomic examination for indications other than evaluation of suspected fetal anatomic abnormalities. Detailed ultrasound fetal anatomic examination is not considered medically necessary for routine screening of normal pregnancy, or in the setting of maternal idiopathic pulmonary hemosiderosis. CPB – Fetal Echocardiograms. Ultrasonography in pregnancy should be performed only when there is a valid medical indication. ACOG stated, “The use of either two-dimensional or three-dimensional ultrasonography only to view the fetus, obtain a picture of the fetus, or determine the fetal sex without a medical indication is inappropriate and contrary to responsible medical practice. This recommendation is based primarily on consensus and expert opinion Level C. ACOG stated that it may be possible to document normal structures before 18 weeks of gestation but some structures can be difficult to visualize at that time because of fetal size, position, and movement; maternal abdominal scars; and increased maternal abdominal wall thickness. A 2nd or 3rd trimester ultrasound examination, however, may pose technical limitations for an anatomic evaluation due to suboptimal imaging, and when this occurs, ACOG recommended documentation of the technical limitation and that a follow-up examination may be helpful. ACOG uses the terms “standard” also called basic , “limited,” and “specialized” also called detailed to describe various types of ultrasound examinations performed during the 2nd or 3rd trimesters.

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It contains no antimicrobial agents. The nominal pH is 5. It allows for drug admixture after connection to a single dose powdered or liquid up to 10 mL drug vial having a 20 mm closure. A breakaway seal in the tube between the vial adaptor and the container is broken to allow transfer of the diluent into the vial and reconstitution of the drug. The reconstituted drug is then transferred from the vial into the container diluent and mixed to result in an admixture for delivery to the patient.

Higher temperatures lead to greater losses. It is unlikely that these minor losses will lead to clinically significant changes within the expiration period. The amount of water that can permeate from inside the container into the overwrap is insufficient to affect the solution significantly. Solutions in contact with the plastic container can leach out certain chemical components from the plastic in very small amounts. However, biological testing was supportive of the safety of the plastic container materials.

It is capable of inducing diuresis depending on the clinical condition of the patient. Stop the infusion immediately if signs or symptoms of a hypersensitivity reaction develop, such as tachycardia, chest pain, dyspnea and flushing. Appropriate therapeutic countermeasures must be instituted as clinically indicated.

The risk of dilutive states is inversely proportional to the electrolyte concentration of the injection.

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