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OB ultrasound

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ajack092:
I have a claim denying for improper procedure code on a triplet ultrasound. CPT 76817, CPT 76811, CPT 76812, and CPT 76812-59. All paid except for the last CPT 76812-59. What is wrong with this code?? Suggestions?? Thanks!!

Michele:
Wow, triplets!  I'm not a certified coder but there really is not enough information to help.  Is that the only denial information?  Did you verify the ICD10 is correct for triplets?  If so I would call the insurance carrier to ask for further explanation. 

ajack092:
LOL!! Ikr??!! Yes that is the only denial reason. I did check the dx codes and I am a certified coder and I am stumped!! It honestly seems correct to me but it obviously is not. Guess I'll call the payer. Thank you!! Have a great day!!

kristin:
Could it be a maximum frequency issue with the payer for the DOS?

Michele:
I thought that but the definition of 76812 states to bill additionally for each gestation. 

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